Cherry Hill Mall Dental LLP

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02139700 Issued in NJ

Legal business name

CHERRY HILL MALL DENTAL LLP

Practice address

2000 Route 38
Suite 2010
Cherry Hill, NJ 08002-2100

Phone

(856) 488-1923

Fax

(856) 488-1926

NPI assigned

Dec 2, 2010

Organization subpart

No

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

Authorized official

Name

Anna A Korol

Title

Office Manager

Phone

(856) 488-1923

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291248000000",
    "number": "1043512643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 ROUTE 38",
            "address_2": "SUITE 2010",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080022100",
            "telephone_number": "856-488-1923",
            "fax_number": "856-488-1926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 ROUTE 38",
            "address_2": "SUITE 2010",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080022100",
            "telephone_number": "856-488-1923",
            "fax_number": "856-488-1926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERRY HILL MALL DENTAL LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-02",
        "last_updated": "2010-12-02",
        "status": "A",
        "authorized_official_last_name": "KOROL",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "856-488-1923"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02139700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.