NPIMap

Organization Active NPI

Tiny Teeth of Lakewood PC

  • Pediatric Dentistry
  • Lakewood, NJ
National Provider Identifier
1104642669
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
TINY TEETH OF LAKEWOOD PC
Practice address
1000 Route 70 Ste 8
Lakewood, NJ 08701-5961
Phone
(848) 245-0779
Fax
(848) 245-0780
NPI assigned
Dec 2, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Authorized official

Name
Dr. Zaki Mustacchi, DDSNPI 1114510716
Title
Owner
Phone
(848) 245-0779

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

1000 Route 70 Ste 8
Lakewood, NJ 08701-5961

Mailing address

1000 Route 70 Ste 8
Lakewood, NJ 08701-5961
Phone (848) 245-0779

National Provider Directory

National Provider Directory

Locations

1000 Route 70
Ste 8
Lakewood, NJ 08701
Phone (848) 245-0779

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1733097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733097600000",
    "number": "1104642669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ROUTE 70 STE 8",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015961",
            "telephone_number": "848-245-0779",
            "fax_number": "848-245-0780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ROUTE 70 STE 8",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015961",
            "telephone_number": "848-245-0779",
            "fax_number": "848-245-0780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TINY TEETH OF LAKEWOOD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-02",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-01",
        "status": "A",
        "authorized_official_last_name": "MUSTACCHI",
        "authorized_official_first_name": "ZAKI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "848-245-0779",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2024; 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.