Montclair Orthodontics, LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

MONTCLAIR ORTHODONTICS, LLC

Practice address

218 Lorraine Ave
Upper Montclair, NJ 07043-1915

Phone

(973) 744-1912

Fax

(973) 744-5955

NPI assigned

Mar 6, 2023

Last updated

Mar 9, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. John Christopher Rubino

Title

Practice Manager

Phone

(973) 744-1912

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1678060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1174223572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 LORRAINE AVE",
            "city": "UPPER MONTCLAIR",
            "state": "NJ",
            "postal_code": "070431915",
            "telephone_number": "973-744-1912",
            "fax_number": "973-744-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 LORRAINE AVE",
            "city": "UPPER MONTCLAIR",
            "state": "NJ",
            "postal_code": "070431915",
            "telephone_number": "973-744-1912",
            "fax_number": "973-744-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTCLAIR ORTHODONTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-06",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A",
        "authorized_official_last_name": "RUBINO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "973-744-1912",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1396930855",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ STATE BOARD OF DENTISTRY",
            "identifier": "22DI01426800",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NJ STATE BOARD OF DENTISTRY",
            "identifier": "22DI02349400",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPPES",
            "identifier": "1134251606",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Upper Montclair, NJ
• Providers in Upper Montclair, NJ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.