Abc Pediatric Dental Care, P.C.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DI020279 Issued in NJ

Legal business name

ABC PEDIATRIC DENTAL CARE, P.C.

Practice address

810 Abbott Blvd Ste 303
Fort Lee, NJ 07024-4116

Phone

(201) 224-9968

Fax

(201) 224-9969

NPI assigned

Oct 3, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Maria K ShinNPI 1801258793

Title

President/Pediatric Dentist

Phone

(201) 224-9968

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Maria Shin, D.D.S.

  • Dentist
  • Fort Lee, NJ
  • NPI 1801258793
  NPD (past) Authorized official

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124112958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 ABBOTT BLVD STE 303",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244116",
            "telephone_number": "201-224-9968",
            "fax_number": "201-224-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 ABBOTT BLVD STE 303",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244116",
            "telephone_number": "201-224-9968",
            "fax_number": "201-224-9969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABC PEDIATRIC DENTAL CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHIN",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT/PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "201-224-9968",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "DI020279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Fort Lee, NJ
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.