Family Dentistry of Keyport LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

FAMILY DENTISTRY OF KEYPORT LLC

Practice address

45 Maple PL
Keyport, NJ 07735-1358

Phone

(732) 246-9411

NPI assigned

Mar 19, 2018

Organization subpart

No

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

Authorized official

Name

Janie Padilla

Title

Manager

Phone

(732) 246-9411

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tatiana Agababaeva, DMD

  • Dentist
  • Bridgeport, CT
  • NPI 1730530577
  NPD (past)

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521417600000",
    "number": "1043714868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 BROOKLAWN AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066042010",
            "telephone_number": "203-334-4837",
            "fax_number": "203-366-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 MAPLE PL",
            "city": "KEYPORT",
            "state": "NJ",
            "postal_code": "077351358",
            "telephone_number": "732-246-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTISTRY OF KEYPORT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-19",
        "last_updated": "2018-03-19",
        "status": "A",
        "authorized_official_last_name": "PADILLA",
        "authorized_official_first_name": "JANIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "732-246-9411"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles M Dietrich, DC
• Nicole Drake, LPC, LCADC, ACS
• Peter Stephen Edwards, D.C.
• Eihab Human Services New Jersey, Inc.
• Endeavor House
• Catherine Filippelli, APN
• Jacqueline Flanagan
• Friends Healthcare
• Friends Healthcare
• Functional Diagnostics PC

• All providers in Keyport, NJ
• Dental Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; 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.