Palisdes Periodontics

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DI15888-01 Issued in NJ

Legal business name

PALISDES PERIODONTICS

Practice address

1530 Palisade Ave
Fort Lee, NJ 07024-5471

Phone

(201) 585-8282

NPI assigned

May 1, 2008

Last updated

May 1, 2008By 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

Dr. Patricia Marrone, DDS

Title

Owner

Phone

(201) 585-8282

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209600000000",
    "number": "1013183896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 PALISADE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245471",
            "telephone_number": "201-585-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 PALISADE AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070245471",
            "telephone_number": "201-585-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALISDES PERIODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-01",
        "last_updated": "2008-05-01",
        "status": "A",
        "authorized_official_last_name": "MARRONE",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-585-8282",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "DI15888-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "DI15888-01",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Palisade Surgery Center LLC
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• Palisades Park Podiatry PC (Choice Podiatry of NJ)
• Palisades Surgical Suites, LLC
• Elizabeth Palughi
• Chang S Park, M.D.
• Clara Park, DDS
• David Park, DPT
• David Spring Park, LAC

• Periodontics in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Periodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2008; 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.