NPIMap

Organization Active NPI

Lawrenceville Dental Associates, LLC

Doing business as Simply Beautiful Smiles of Lawrenceville

  • Dentist
  • Lawrenceville, NJ
National Provider Identifier
1114216496
Registry record updated Apr 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI01462203 Issued in NJ
Legal business name
LAWRENCEVILLE DENTAL ASSOCIATES, LLC
Doing business as
Simply Beautiful Smiles of Lawrenceville
Practice address
1200 Lawrenceville Rd
Suite 2
Lawrenceville, NJ 08648-3551
Phone
(609) 883-1770
Fax
(609) 883-1777
NPI assigned
Apr 7, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2011

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

Authorized official

Name
Dr. Charles J Rose, DMD
Title
Owner
Phone
(609) 883-1770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 22DI01462203 NJ Primary

Addresses

Primary practice location

1200 Lawrenceville Rd
Suite 2
Lawrenceville, NJ 08648-3551

Mailing address

1200 Lawrenceville Rd
Suite 2
Lawrenceville, NJ 08648-3551
Phone (609) 883-1770

Other names 1

  • Simply Beautiful Smiles of Lawrenceville Doing business as

National Provider Directory

National Provider Directory

Locations

1200 Lawrenceville Rd
Ste 2
Lawrenceville, NJ 08648
Phone (609) 883-1770

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302134400000",
    "number": "1114216496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 LAWRENCEVILLE RD",
            "address_2": "SUITE 2",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086483551",
            "telephone_number": "609-883-1770",
            "fax_number": "609-883-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 LAWRENCEVILLE RD",
            "address_2": "SUITE 2",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086483551",
            "telephone_number": "609-883-1770",
            "fax_number": "609-883-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAWRENCEVILLE DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-07",
        "last_updated": "2011-04-07",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-883-1770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI01462203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Simply Beautiful Smiles of Lawrenceville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lawrenceville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.