Glow Dental Spa P.C.

Primary specialty

DentistTaxonomy code 122300000X

License

DI020826 Issued in NJ

Legal business name

GLOW DENTAL SPA P.C.

Practice address

506 Hamburg Tpke
Suite 101
Wayne, NJ 07470-2068

Phone

(973) 942-6550

Fax

(973) 942-6553

NPI assigned

Sep 3, 2015

Last updated

Sep 3, 2015By 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

Behshad Ahkami, D.D.S.

Title

Doctor

Phone

(973) 942-6550

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441238400000",
    "number": "1033587381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 HAMBURG TPKE",
            "address_2": "SUITE 101",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702068",
            "telephone_number": "973-942-6550",
            "fax_number": "973-942-6553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 HAMBURG TPKE",
            "address_2": "SUITE 101",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074702068",
            "telephone_number": "973-942-6550",
            "fax_number": "973-942-6553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLOW DENTAL SPA P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-03",
        "last_updated": "2015-09-03",
        "status": "A",
        "authorized_official_last_name": "AHKAMI",
        "authorized_official_first_name": "BEHSHAD",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "973-942-6550",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI020826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "24362NJ",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Giordano
• Gameel Girgis, RPH
• Svetlana Gladoun, D.O.
• Eduardo Glass, DPM
• Matthew Franklin Gliksman, MD
• Corey R Glynn, LCSW
• Andrew W. Gnoy, M.D.
• Timothy Godfrey, PA
• Heidi M Godoy, DPM
• Irma G Godoy, DPM

• Dentist in Wayne, NJ
• Providers in Wayne, 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 3, 2015; 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.