Bergen Prosthodontics LLC

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

Legal business name

BERGEN PROSTHODONTICS LLC

Practice address

102 Chestnut Ridge Rd Ste 201
Montvale, NJ 07645-1856

Phone

(201) 582-2264

NPI assigned

Dec 15, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Sung Eun Kim, DMD, MMSCNPI 1780170522

Title

Ceo/Dentist

Phone

(201) 582-2264

Specialties & licenses 1

Addresses

Other names 1

• MONTVALE PROSTHODONTICS 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.

• Sung Eun Kim

  • Dentist
  • Boston, MA
  • NPI 1780170522
  NPD Authorized official

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

{
    "created_epoch": "1702598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702598400000",
    "number": "1043088396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 GARNET DR",
            "city": "WOODLAND PARK",
            "state": "NJ",
            "postal_code": "074244215",
            "telephone_number": "201-988-5633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CHESTNUT RIDGE RD STE 201",
            "city": "MONTVALE",
            "state": "NJ",
            "postal_code": "076451856",
            "telephone_number": "201-582-2264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGEN PROSTHODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-15",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "SUNG EUN",
        "authorized_official_title_or_position": "CEO/DENTIST",
        "authorized_official_telephone_number": "201-582-2264",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MMSC"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MONTVALE PROSTHODONTICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Luiza Bauta
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• Casey A Bayne, DPT
• Henry Benvenisti, PHD CLINICAL PSYCH
• Bergen Heart Center, PC
• Bergen Rnfa LLC
• Asher Berko
• Margaret Berlinger
• Ryan Berube, ATC
• Raina Pandya Bhanderi, APRN

• Prosthodontics in Montvale, NJ
• Providers in Montvale, NJ by specialty
• Prosthodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.