Renaissance Dental Group, PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

RENAISSANCE DENTAL GROUP, PC

Practice address

596 Anderson Ave
Suite# 206a
Cliffside Park, NJ 07010

Phone

(201) 840-7777

Fax

(201) 840-0377

NPI assigned

May 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Anita Shulman, DDSNPI 1134130461

Title

President

Phone

(201) 840-7777

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Locations

Practitioners 2

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

• Anita Shulman, DDS

  • Dentist
  • Cliffside Park, NJ
  • NPI 1134130461
  Medicare reassignment Authorized official
• Mikhail Shulman, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Cliffside Park, NJ
  • NPI 1346251675
  Medicare reassignment

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715126400000",
    "number": "1073725248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "596 ANDERSON AVE",
            "address_2": "SUITE# 206A",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "07010",
            "telephone_number": "201-840-7777",
            "fax_number": "201-840-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "596 ANDERSON AVE",
            "address_2": "SUITE# 206A",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "07010",
            "telephone_number": "201-840-7777",
            "fax_number": "201-840-0377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE DENTAL GROUP, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A",
        "authorized_official_last_name": "SHULMAN",
        "authorized_official_first_name": "ANITA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-840-7777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Valerie D. Rawls, LCSW
• Real Sleep Solutions NJ LLC
• Real Smile Dental Inc.
• Reliant Diagnostics, LLC
• Tina M Rellinger
• Renaissance General Medicine PC
• Ansimon Rezk
• Rachel Y Rhodes, DPT
• Ari Rieser, P.T.
• Richard Norman Righthand, M.D.

• Dental Clinic/Center in Cliffside Park, NJ
• Providers in Cliffside Park, 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 May 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.