Medford Periodontal Associates, LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

22DI01653900 Issued in NJ

Legal business name

MEDFORD PERIODONTAL ASSOCIATES, LLC

Practice address

30 Jackson Rd
Suite a-5
Medford, NJ 08055-9283

Phone

(609) 953-3700

NPI assigned

Dec 19, 2007

Organization subpart

No

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

Authorized official

Name

Bernard Calem, DMDNPI 1992808547

Title

Owner

Phone

(609) 953-3700

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Bernard Calem, DMD

  • Periodontics
  • Moorestown, NJ
  • NPI 1992808547
  NPD (past) Authorized official

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

{
    "created_epoch": "1198022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723507200000",
    "number": "1184808743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 JACKSON RD",
            "address_2": "SUITE A-5",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080559283",
            "telephone_number": "609-953-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 JACKSON RD",
            "address_2": "SUITE A-5",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080559283",
            "telephone_number": "609-953-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFORD PERIODONTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-19",
        "last_updated": "2024-08-13",
        "status": "A",
        "authorized_official_last_name": "CALEM",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-953-3700",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22DI01653900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medford Family and Cosmetic Dentistry
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• Medford Family Pharmacy LLC (Medford Family Pharmacy)
• Medford Foot Specialists LLC
• Medford Medical Supply, LLC
• Medford Pharmacy
• Medford Pharmacy
• Medford Pharmacy LLC
• Medford Shoprite, Inc.
• Medford Township Public School

• Periodontics in Medford, NJ
• Providers in Medford, NJ by specialty
• Periodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2024; 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.