NPIMap

Organization Active NPI

Dental of Clementon

  • General Practice Dentistry
  • Clementon, NJ
National Provider Identifier
1205453032
Registry record updated Jun 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
DENTAL OF CLEMENTON
Practice address
250 Gibbsboro Rd
Clementon, NJ 08021-4130
Phone
(856) 783-3300
NPI assigned
Jun 27, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2020

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

Authorized official

Name
Dr. Samantha Wolff, DDSNPI 1154718963
Title
Owner
Phone
(856) 783-3300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X
Public Health DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223D0001X
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

250 Gibbsboro Rd
Clementon, NJ 08021-4130

Mailing address

250 Gibbsboro Rd
Clementon, NJ 08021-4130
Phone (856) 783-3300

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1593216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593216000000",
    "number": "1205453032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 GIBBSBORO RD",
            "city": "CLEMENTON",
            "state": "NJ",
            "postal_code": "080214130",
            "telephone_number": "856-783-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 GIBBSBORO RD",
            "city": "CLEMENTON",
            "state": "NJ",
            "postal_code": "080214130",
            "telephone_number": "856-783-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL OF CLEMENTON",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-27",
        "last_updated": "2020-06-27",
        "certification_date": "2020-06-27",
        "status": "A",
        "authorized_official_last_name": "WOLFF",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-783-3300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clementon, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.