Bloomfield Ave Dental, LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

BLOOMFIELD AVE DENTAL, LLC

Practice address

223 Bloomfield Ave
Newark, NJ 07104-1104

Phone

(973) 715-5963

NPI assigned

Jul 6, 2022

Organization subpart

No

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

Authorized official

Name

Michael E. Skolnick, DMD

Title

Ceo

Phone

(973) 715-5963

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657065600000",
    "number": "1114650231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 BLOOMFIELD AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071041104",
            "telephone_number": "973-715-5963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 BLOOMFIELD AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071041104",
            "telephone_number": "973-715-5963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMFIELD AVE DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-06",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A",
        "authorized_official_last_name": "SKOLNICK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "973-715-5963",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Marie Blesson, R.PH.
• Nikolas Anthony Bletnitsky
• Sergey Blintsovskiy, MD
• Samantha Block, MD
• Bloomfield Ave Dental Spec, LLC
• Bloomfield Health Pavilion LLC
• Bloomfield Hospital Physicians, P.a.
• Blue Aid Home Care LLC
• Blue Medical Diagnostics East
• Blue Star Medical Transport

• Dentist in Newark, NJ
• Providers in Newark, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2022; 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.