East Brunswick Periodontics and Dental Implants

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

20508 Issued in NJ

Legal business name

EAST BRUNSWICK PERIODONTICS AND DENTAL IMPLANTS

Practice address

E 7 Brier Hill CT
East Brunswick, NJ 08816-3336

Phone

(732) 651-8470

Fax

(732) 651-8033

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Nima Mir Madjlessi, DDS, MS, PANPI 1659303329

Title

Doctor

Phone

(732) 651-8470

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Nima Mir Madjlessi, DDS,MSD,PA

  • Periodontics
  • East Brunswick, NJ
  • NPI 1659303329
  NPD (past) Authorized official

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194861591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "E 7 BRIER HILL CT",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163336",
            "telephone_number": "732-651-8470",
            "fax_number": "732-651-8033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "E 7 BRIER HILL CT",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163336",
            "telephone_number": "732-651-8470",
            "fax_number": "732-651-8033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BRUNSWICK PERIODONTICS AND DENTAL IMPLANTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIR MADJLESSI",
        "authorized_official_first_name": "NIMA",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "732-651-8470",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS, PA"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "20508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NATIONAL PROVIDER IDENTIF",
            "identifier": "1659303329",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East Brunswick Imaging Center LLC
• East Brunswick New Image Dental LLC
• East Brunswick Open Upright MRI LLC
• East Brunswick Orthopedic Associates LLC
• East Brunswick Pediatrics Associated
• East Brunswick Physical Therapy
• East Brunswick Primary Care, PA
• East Brunswick Public Schools
• East Brunswick Rehabilitation LLC
• East Brunswick Rescue Squad

• Periodontics in East Brunswick, NJ
• Providers in East Brunswick, 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 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.