NPIMap

Organization Active NPI

Wortzel Integrative Dental Care, LLC

  • Dentist
  • Mountainside, NJ
National Provider Identifier
1144625856
Registry record updated Oct 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22D101187000 Issued in NJ
Legal business name
WORTZEL INTEGRATIVE DENTAL CARE, LLC
Practice address
1122 Route 22
Mountainside, NJ 07092-2812
Phone
(908) 654-5151
Fax
(908) 654-7791
NPI assigned
Oct 24, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2014

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

Authorized official

Name
Dr. Robert A Wortzel, DMDNPI 1770732901
Title
Dentist
Phone
(908) 654-5151

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 22D101187000 NJ Primary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 22D102559900 NJ
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X 22D102558000 NJ

Addresses

Primary practice location

1122 Route 22
Mountainside, NJ 07092-2812

Mailing address

1122 Route 22
Mountainside, NJ 07092-2812
Phone (908) 654-5151

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1414108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414108800000",
    "number": "1144625856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 ROUTE 22",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922812",
            "telephone_number": "908-654-5151",
            "fax_number": "908-654-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 ROUTE 22",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070922812",
            "telephone_number": "908-654-5151",
            "fax_number": "908-654-7791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WORTZEL INTEGRATIVE DENTAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-24",
        "last_updated": "2014-10-24",
        "status": "A",
        "authorized_official_last_name": "WORTZEL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "908-654-5151",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22D101187000",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22D102559900",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22D102558000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountainside, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2014; 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.