GD NJ Randolph LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

GD NJ RANDOLPH LLC

Doing business as

Smith Family Dentistry

Practice address

2 W Hanover Ave Ste 201
Randolph, NJ 07869-4222

Phone

(973) 895-5111

NPI assigned

Oct 31, 2023

Last updated

Oct 31, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Chad Hendricks

Title

Credentialing

Phone

(612) 859-0444

Specialties & licenses 1

Addresses

Other names 1

• Smith Family Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Edward Jay Smith, DMD

  • Dentist
  • Randolph, NJ
  • NPI 1720116296
  NPD (past)

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

{
    "created_epoch": "1698710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1003689233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 W HANOVER AVE STE 201",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078694222",
            "telephone_number": "973-895-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 W HANOVER AVE STE 201",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078694222",
            "telephone_number": "973-895-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GD NJ RANDOLPH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-31",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "HENDRICKS",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "612-859-0444"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smith Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Gary S Brennan LPC Cadc NCC Psychological and Addiction Services LLC
• Gary S. Safier DO, PC
• Kenneth Wesley Gates, PSY.D.
• Sergio C Gatoulis, PHARMD
• Gautam Desai MD PA
• Heidi Gebhard
• Beth P Gelman, M.D.
• Scott Franklin Gelman, M.D.
• Erica Cristina Geraci, PSYCHOLOGIST
• Jack Gershenhorn, DDS

• General Practice Dentistry in Randolph, NJ
• Providers in Randolph, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.