Pediatric Dentistry of South Jersey, P.C.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DI16646 Issued in NJ

Legal business name

PEDIATRIC DENTISTRY OF SOUTH JERSEY, P.C.

Practice address

3071 E Chestnut Ave
Suite D-10
Vineland, NJ 08361-7847

Phone

(856) 205-0099

Fax

(856) 205-1633

NPI assigned

Dec 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. William R Beck, D.M.D.NPI 1922281765

Title

Owner

Phone

(856) 205-0099

Specialties & licenses 1

Addresses

Practitioners 1

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

• William R Beck, D.M.D.

  • Pediatric Dentistry
  • Vineland, NJ
  • NPI 1922281765
  NPD (past) Authorized official

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

{
    "created_epoch": "1197763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197763200000",
    "number": "1104009943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3071 E CHESTNUT AVE",
            "address_2": "SUITE D-10",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083617847",
            "telephone_number": "856-205-0099",
            "fax_number": "856-205-1633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3071 E CHESTNUT AVE",
            "address_2": "SUITE D-10",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083617847",
            "telephone_number": "856-205-0099",
            "fax_number": "856-205-1633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY OF SOUTH JERSEY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-16",
        "last_updated": "2007-12-16",
        "status": "A",
        "authorized_official_last_name": "BECK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-205-0099",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "DI16646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Magelende S Paviera, MSN, RN, AGNP-NC
• Ian Michael Pawasarat, DO
• Ryan Pearson
• Pedersen Family Medicine, LLC
• Pediatric Associates LLC
• Iris Perez, FNP
• Timothy Perkins, LCSW
• David Robert Pernelli, M.D.
• Personal Health Care for Women, PA
• Allison Rose Peters

• Pediatric Dentistry in Vineland, NJ
• Providers in Vineland, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2007; 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.