Palisades Dental Associates PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

17487 Issued in NJ

Legal business name

PALISADES DENTAL ASSOCIATES PC

Practice address

1355 15TH St
Suite 230
Fort Lee, NJ 07024-2039

Phone

(201) 585-8585

Fax

(201) 585-5032

NPI assigned

Apr 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Michael Brown, D.M.D,

Title

Vice President

Phone

(201) 585-8585

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124247481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 15TH ST",
            "address_2": "SUITE 230",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070242039",
            "telephone_number": "201-585-8585",
            "fax_number": "201-585-5032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 15TH ST",
            "address_2": "SUITE 230",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070242039",
            "telephone_number": "201-585-8585",
            "fax_number": "201-585-5032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALISADES DENTAL ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "201-585-8585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D,"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "17487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• General Practice 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.