Newport Centre Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19779 Issued in NJ

Legal business name

NEWPORT CENTRE DENTAL

Practice address

30-152 A Mall Drive West
Jersey City, NJ 07310

Phone

(201) 626-2500

Fax

(201) 626-2502

NPI assigned

May 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Alexander Mikhailov, D.D.S

Title

Owner

Phone

(201) 626-2500

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174736458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30-152 A MALL DRIVE WEST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07310",
            "telephone_number": "201-626-2500",
            "fax_number": "201-626-2502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30-152 A MALL DRIVE WEST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "07310",
            "telephone_number": "201-626-2500",
            "fax_number": "201-626-2502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWPORT CENTRE DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIKHAILOV",
        "authorized_official_first_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-626-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "19779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Jersey City, NJ
• Providers in Jersey City, 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.