NPIMap

Organization Active NPI

Mitchell Brudno DMD LLC

  • Dentist
  • Cherry Hill, NJ
National Provider Identifier
1154443026
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
NJDI15818 Issued in NJ
Legal business name
MITCHELL BRUDNO DMD LLC
Practice address
1021 Marlton Pike West
Cherry Hill, NJ 08002
Phone
(856) 429-4249
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mitchell Brudno, DMDNPI 1144611617
Title
Owner Sole Member LLC
Phone
(856) 429-4249

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X NJDI15818 NJ Primary

Addresses

Primary practice location

1021 Marlton Pike West
Cherry Hill, NJ 08002

Mailing address

1021 Marlton Pike West
Cherry Hill, NJ 08002
Phone (856) 429-4249

Other names 1

  • LLC Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154443026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 MARLTON PIKE WEST",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "08002",
            "telephone_number": "856-429-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1021 MARLTON PIKE WEST",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "08002",
            "telephone_number": "856-429-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELL BRUDNO DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRUDNO",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_title_or_position": "OWNER SOLE MEMBER LLC",
        "authorized_official_telephone_number": "856-429-4249",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "NJDI15818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cherry Hill, NJ

Sources for this page

  • 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.