NPIMap

Organization Active NPI

Robert Wood Johnson University Hospital Dental Suite

  • Dental Clinic/Center
  • New Brunswick, NJ
National Provider Identifier
1063561025
Registry record updated Dec 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DI019921 Issued in NJ
Legal business name
ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL DENTAL SUITE
Practice address
1 Robert Wood Johnson PL
Dental Suite
New Brunswick, NJ 08901-1928
Phone
(732) 937-8653
Fax
(732) 253-3575
NPI assigned
Jan 9, 2007
Last updated
Dec 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2011

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

Authorized official

Name
Ms. Jacqueline S. Reid, DDS
Title
Director, Dental Suite
Phone
(732) 937-8653

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DI019921 NJ Primary

Addresses

Primary practice location

1 Robert Wood Johnson PL
Dental Suite
New Brunswick, NJ 08901-1928

Mailing address

1 Robert Wood Johnson PL
Dental Suite
New Brunswick, NJ 08901-1928
Phone (732) 937-8653

Other identifiers 1

IdentifierTypeStateIssuer
4137710MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Robert Wood Johnson University Hospital Dental Suite6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323907200000",
    "number": "1063561025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ROBERT WOOD JOHNSON PL",
            "address_2": "DENTAL SUITE",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011928",
            "telephone_number": "732-937-8653",
            "fax_number": "732-253-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROBERT WOOD JOHNSON PL",
            "address_2": "DENTAL SUITE",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011928",
            "telephone_number": "732-937-8653",
            "fax_number": "732-253-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL DENTAL SUITE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2011-12-15",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "DIRECTOR, DENTAL SUITE",
        "authorized_official_telephone_number": "732-937-8653",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NJ",
            "license": "DI019921",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4137710",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2011; 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.