Active NPI
Bergenline Dental Group
- General Practice Dentistry
- Union City, NJ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22907
- Legal business name
- BERGENLINE DENTAL GROUP
- Practice address
- 3916 Bergenline Ave
2ND Floor
Union City, NJ 07087-1612 - Phone
- (201) 865-5150
- Fax
- (201) 865-5962
- NPI assigned
- May 21, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Peter Fuentes, DMD
- Title
- Owner/President
- Phone
- (201) 865-5150
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22907 | NJ | Primary |
Addresses
Primary practice location
3916 Bergenline Ave
2ND Floor
Union City, NJ 07087-1612
Mailing address
3916 Bergenline Ave
2ND Floor
Union City, NJ 07087-1612
Phone (201) 865-5150
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0154831 | Medicaid | NJ |
National Provider Directory
National Provider Directory- Tax ID family
- Bergenline Dental Group
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Dentist
- Paterson, NJ
- NPI 1679919252
Locations
3916 Bergenline Ave
Ste 2
Union City, NJ 07087
Phone (201) 865-5150
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- General Practice Dentistry
- Union City, NJ
- NPI 1538214168
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211328000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1211328000000",
"number": "1043477565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3916 BERGENLINE AVE",
"address_2": "2ND FLOOR",
"city": "UNION CITY",
"state": "NJ",
"postal_code": "070871612",
"telephone_number": "201-865-5150",
"fax_number": "201-865-5962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3916 BERGENLINE AVE",
"address_2": "2ND FLOOR",
"city": "UNION CITY",
"state": "NJ",
"postal_code": "070871612",
"telephone_number": "201-865-5150",
"fax_number": "201-865-5962"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BERGENLINE DENTAL GROUP",
"organizational_subpart": "NO",
"enumeration_date": "2008-05-21",
"last_updated": "2008-05-21",
"status": "A",
"authorized_official_last_name": "FUENTES",
"authorized_official_first_name": "PETER",
"authorized_official_title_or_position": "OWNER/PRESIDENT",
"authorized_official_telephone_number": "201-865-5150",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DMD"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "22907",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0154831",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Union City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.