NPIMap

Organization Active NPI

Passaic Dental Association

  • General Practice Dentistry
  • Passaic, NJ
National Provider Identifier
1184861114
Registry record updated Jan 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02093500 Issued in NJ
Legal business name
PASSAIC DENTAL ASSOCIATION
Practice address
244 Paulison Ave
Passaic, NJ 07055-3806
Phone
(973) 778-7272
Fax
(973) 778-5755
NPI assigned
Jan 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2009

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

Authorized official

Name
Ms. Monica Rollins
Title
Office Manager
Phone
(973) 778-7272

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 22DI02093500 NJ Primary

Addresses

Primary practice location

244 Paulison Ave
Passaic, NJ 07055-3806

Mailing address

244 Paulison Ave
Passaic, NJ 07055-3806
Phone (973) 778-7272

Other identifiers 1

IdentifierTypeStateIssuer
0180041MedicaidNJ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1231804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231804800000",
    "number": "1184861114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 PAULISON AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070553806",
            "telephone_number": "973-778-7272",
            "fax_number": "973-778-5755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 PAULISON AVE",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070553806",
            "telephone_number": "973-778-7272",
            "fax_number": "973-778-5755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PASSAIC DENTAL ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-13",
        "last_updated": "2009-01-13",
        "status": "A",
        "authorized_official_last_name": "ROLLINS",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "973-778-7272",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02093500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0180041",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2009; 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.