Garden State Oral Surgery PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DI15472 Issued in NJ

Legal business name

GARDEN STATE ORAL SURGERY PA

Practice address

265 Baldwin Rd
Parsippany, NJ 07054-2007

Phone

(973) 335-5252

NPI assigned

Feb 4, 2008

Last updated

Feb 4, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John N Kallis, DMD

Title

Owner

Phone

(973) 335-5252

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202083200000",
    "number": "1063690816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 BALDWIN RD",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070542007",
            "telephone_number": "973-335-5252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 BALDWIN RD",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "070542007",
            "telephone_number": "973-335-5252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN STATE ORAL SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-04",
        "last_updated": "2008-02-04",
        "status": "A",
        "authorized_official_last_name": "KALLIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-335-5252",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "DI15472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn Eileen Gaesser, APRN
• Khilmattee Gangasarran, APN
• Angela P Garces, APN
• Christine Garcia, LAC., LMT
• Garden State Eye and Vision LLC
• Garden State Orthopaedic Associates,P.a.
• Garden State Sports Medicine LLC (GS Sports Med)
• Daniel Joseph Gardner
• Disha Gehani, IBCLC
• Cassandra Generelli, BCBA

• Oral and Maxillofacial Surgery (Dentist) in Parsippany, NJ
• Providers in Parsippany, NJ by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2008; 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.