Bergen Line Endodontics LLC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

BERGEN LINE ENDODONTICS LLC

Practice address

5918 Bergenline Ave
Suite 201 B
West New York, NJ 07093-1392

Phone

(201) 861-2900

Fax

(201) 662-9662

NPI assigned

Oct 30, 2009

Organization subpart

No

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

Authorized official

Name

Viktoria Demianenko

Title

Office Manager

Phone

(718) 373-6707

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1256860800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256860800000",
    "number": "1023344736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5918 BERGENLINE AVE",
            "address_2": "SUITE 201 B",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070931392",
            "telephone_number": "201-861-2900",
            "fax_number": "201-662-9662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5918 BERGENLINE AVE",
            "address_2": "SUITE 201 B",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070931392",
            "telephone_number": "201-861-2900",
            "fax_number": "201-662-9662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGEN LINE ENDODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-30",
        "last_updated": "2009-10-30",
        "status": "A",
        "authorized_official_last_name": "DEMIANENKO",
        "authorized_official_first_name": "VIKTORIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "718-373-6707"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ramon E. Batista, D.D.S.
• Heriberto Bedoya, RPH
• Bella Vida Home Health Services, Inc
• Sulaimy Benitez
• Bergen Family Pharmacy, Inc.
• Bergenline Family Medicine
• Bergenline Health Care, LLC
• Bergenline Optometry PC
• Bergenline Orthodontics, LLC
• Bergenline Spine and Healthcare Center PC

• Endodontics in West New York, NJ
• Providers in West New York, NJ by specialty
• Endodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; 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.