NPIMap

Organization Active NPI

21St Ave Dental LLC

  • Dentist
  • Paterson, NJ
National Provider Identifier
1114203387
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14409 Issued in NJ
Legal business name
21ST AVE DENTAL LLC
Practice address
318 21St Ave
Paterson, NJ 07501-3538
Phone
(973) 742-1991
NPI assigned
Nov 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2011

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

Authorized official

Name
Dr. Patrick E Ryan, DMD
Title
Owner
Phone
(973) 742-1991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 14409 NJ Primary

Addresses

Primary practice location

318 21St Ave
Paterson, NJ 07501-3538

Mailing address

318 21St Ave
Paterson, NJ 07501-3538
Phone (973) 742-1991

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1320105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320105600000",
    "number": "1114203387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "318 21ST AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075013538",
            "telephone_number": "973-742-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "318 21ST AVE",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075013538",
            "telephone_number": "973-742-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "21ST AVE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-01",
        "last_updated": "2011-11-01",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-742-1991",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "14409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2011; 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.