Dental of Lodi PC

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02602300 Issued in NJ

Legal business name

DENTAL OF LODI PC

Practice address

1 S Main St Ste 6
Lodi, NJ 07644-2235

Phone

(973) 302-2066

NPI assigned

Sep 15, 2016

Organization subpart

No

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

Authorized official

Name

Vikas Gupta

Title

Dentist

Phone

(973) 302-2066

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1473897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473897600000",
    "number": "1003364332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 S MAIN ST STE 6",
            "city": "LODI",
            "state": "NJ",
            "postal_code": "076442235",
            "telephone_number": "973-302-2066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 S MAIN ST STE 6",
            "city": "LODI",
            "state": "NJ",
            "postal_code": "076442235",
            "telephone_number": "973-302-2066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL OF LODI PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-15",
        "last_updated": "2016-09-15",
        "status": "A",
        "authorized_official_last_name": "GUPTA",
        "authorized_official_first_name": "VIKAS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "973-302-2066"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02602300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1215357637",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1750788402",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberley Coronel
• Sanique R Davis Atkins, LPN
• Nathalie De Jesus de Jesus
• Frank J. Degeorge, O.D.
• Dental Associates of Lodi
• Robert L Destefano, D.C.
• Bharatkumar Ravji Dholariya
• Philip M Dipasquale, DC, PA
• Dr Frank Degeorge
• Dr Frank Degeorge

• Dentist in Lodi, NJ
• Providers in Lodi, 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 15, 2016; 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.