Kinnelon Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

DI02262300 Issued in NJ

Legal business name

KINNELON DENTAL GROUP

Practice address

11 Kiel Ave
Kinnelon, NJ 07405-2549

Phone

(973) 838-5585

Fax

(973) 838-6258

NPI assigned

Dec 6, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jessica Lee Logan, D.M.D.

Title

Employee

Phone

(973) 838-5585

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1165363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073671392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 KIEL AVE",
            "city": "KINNELON",
            "state": "NJ",
            "postal_code": "074052549",
            "telephone_number": "973-838-5585",
            "fax_number": "973-838-6258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 KIEL AVE",
            "city": "KINNELON",
            "state": "NJ",
            "postal_code": "074052549",
            "telephone_number": "973-838-5585",
            "fax_number": "973-838-6258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINNELON DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LOGAN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "EMPLOYEE",
        "authorized_official_telephone_number": "973-838-5585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI02262300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jo-Ann Szylit, MD
• Gina M Karnisovas, MA, EDS, NCC, LPC
• Zachary Katzman, DPT
• Alexander Kellish
• Gabriella Kellish
• Kinnelon Dermatology Associates PC
• Kinnelon Medical & Pediatric Associates, PA
• Kinnelon Medical & Wellness Associates LLC
• Kinnelon Physical Therapy Inc
• Kinnelon Public Schools

• Dentist in Kinnelon, NJ
• Providers in Kinnelon, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.