South Jersey Dental Studio LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

SOUTH JERSEY DENTAL STUDIO LLC

Practice address

539 Marlton Pike W
Cherry Hill, NJ 08002

Phone

(856) 406-6570

NPI assigned

Sep 28, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Dara Nikoonezhad, DMD

Title

Owner/Dentist

Phone

(732) 615-8087

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1664323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664323200000",
    "number": "1053035576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 MARLTON PIKE W",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "08002",
            "telephone_number": "856-406-6570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 MARLTON PIKE W",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "08002",
            "telephone_number": "856-406-6570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JERSEY DENTAL STUDIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-28",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-27",
        "status": "A",
        "authorized_official_last_name": "NIKOONEZHAD",
        "authorized_official_first_name": "DARA",
        "authorized_official_title_or_position": "OWNER/DENTIST",
        "authorized_official_telephone_number": "732-615-8087",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sandiya Soundara
• Teresa Sousa, MSN, FNP-BC
• South Jersey Allergy and Asthma Assoc
• South Jersey Behavioral Health Resources Incorporated
• South Jersey Center for Inflammatory Disease'S
• South Jersey Developmental Pediatrics LLC
• South Jersey Ear Nose & Throat Associates P a
• South Jersey Endodontics, PA
• South Jersey Family Dental LLC
• South Jersey Geriatric Care, PC

• Dental Clinic/Center in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Dental Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; 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.