Ismile Dental Associates

Primary specialty

DentistTaxonomy code 122300000X

License

DI02584500 Issued in NJ

Legal business name

ISMILE DENTAL ASSOCIATES

Practice address

22 N Washington Ave.
Bergenfield, NJ 07621

Phone

(201) 374-1558

Fax

(201) 374-1559

NPI assigned

Sep 29, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Soo Jin Chang

Title

DDS

Phone

(201) 374-1558

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1411948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411948800000",
    "number": "1003219536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 N WASHINGTON AVE.",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "07621",
            "telephone_number": "201-374-1558",
            "fax_number": "201-374-1559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 N WASHINGTON AVE.",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "07621",
            "telephone_number": "201-374-1558",
            "fax_number": "201-374-1559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ISMILE DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-29",
        "last_updated": "2014-09-29",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "SOO JIN",
        "authorized_official_title_or_position": "DDS",
        "authorized_official_telephone_number": "201-374-1558"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI02584500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Bergenfield, NJ
• Providers in Bergenfield, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.