Modern Family Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02454300 Issued in NJ

Legal business name

MODERN FAMILY DENTISTRY

Practice address

551 Jersey Ave
Ground Floor
Jersey City, NJ 07302-2788

Phone

(917) 561-7256

NPI assigned

Nov 20, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer Marin, DMD

Title

Manager

Phone

(917) 561-7256

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1384905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384905600000",
    "number": "1184054645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 JERSEY AVE",
            "address_2": "GROUND FLOOR",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073022788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "551 JERSEY AVE",
            "address_2": "GROUND FLOOR",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073022788",
            "telephone_number": "917-561-7256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-20",
        "last_updated": "2013-11-20",
        "status": "A",
        "authorized_official_last_name": "MARIN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "917-561-7256",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02454300",
            "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 Nov 20, 2013; 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.