South Bergen Oral Maxillofacial Surgery LLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

22DI02285405 Issued in NJ

Legal business name

SOUTH BERGEN ORAL MAXILLOFACIAL SURGERY LLC

Practice address

422 Stuyvesant Ave
1St Floor
Lyndhurst, NJ 07071-2326

Phone

(201) 935-4577

NPI assigned

Mar 4, 2016

Organization subpart

No

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

Authorized official

Name

Eshansh Arora

Title

Member

Phone

(201) 935-4577

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1457049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457049600000",
    "number": "1073973939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 STUYVESANT AVE",
            "address_2": "1ST FLOOR",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070712326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 STUYVESANT AVE",
            "address_2": "1ST FLOOR",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "070712326",
            "telephone_number": "201-935-4577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BERGEN ORAL MAXILLOFACIAL SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-04",
        "last_updated": "2016-03-04",
        "status": "A",
        "authorized_official_last_name": "ARORA",
        "authorized_official_first_name": "ESHANSH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "201-935-4577"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI02285405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Divya N Sivasankaran, LAC, NCC
• SKR Medical Advisors
• Zulieta Smoljan, LMSW
• Rosa Maria Solano-Trelles
• Jin Myung Soun, PHARM D
• South Bergen Oral Surgery PA
• Vincent G Spinazzola, D.C.
• St John of Lotus Healthcare Services Inc
• Steve Fallek MD
• Diane J Strickland

• Oral and Maxillofacial Surgery (Dentist) in Lyndhurst, NJ
• Providers in Lyndhurst, 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 Mar 4, 2016; 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.