CLZZ Dental LLC

Key facts

NPI

1063148302

Entity type

Organization (NPI type 2)

Primary specialty

Dental Clinic/Center 261QD0000X

Legal business name

CLZZ DENTAL LLC

Practice address

315 Route 206 Ste 903
Hillsborough, NJ 08844-4625

Phone

(732) 532-5554

NPI assigned

Jul 28, 2022

Organization subpart

No

Authorized official

Name

Dr. Ricken Patel, DMD NPI 1396005203

Title

Co-Owner

Phone

(732) 213-0036

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 1

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

• Ricken Patel Dentist · Cherry Hill, NJ · NPI 1396005203
  NPD Authorized official

National Provider Directory

Locations

Specialties & licenses

Addresses

Other names

• Promenade Smiles Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 28, 2022.

{
    "created_epoch": "1658966400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1063148302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EXECUTIVE DR STE 102",
            "city": "MONMOUTH JUNCTION",
            "state": "NJ",
            "postal_code": "088522446",
            "telephone_number": "732-422-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 ROUTE 206 STE 903",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088444625",
            "telephone_number": "732-532-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLZZ DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-28",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "RICKEN",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "732-213-0036",
        "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": [
        {
            "organization_name": "Promenade Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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All providers in Hillsborough, NJ · Dental Clinic/Center in New Jersey