NPIMap

Organization Active NPI

Summit Dentist

  • Dentist
  • Summit, NJ
National Provider Identifier
1205833498
Registry record updated Aug 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22-DI02025200 Issued in NJ
Legal business name
SUMMIT DENTIST
Practice address
52 Deforest Ave
3Rd Floor
Summit, NJ 07901-1930
Phone
(908) 273-3873
Fax
(908) 273-0905
NPI assigned
Jul 1, 2005
Last updated
Aug 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2013

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

Authorized official

Name
Dr. Mindy Ok, DMDNPI 1285882159
Title
Owner
Phone
(908) 273-3873

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22-DI02025200 NJ Primary

Addresses

Primary practice location

52 Deforest Ave
3Rd Floor
Summit, NJ 07901-1930

Mailing address

52 Deforest Ave
3Rd Floor
Summit, NJ 07901
Phone (908) 273-3873

Other names 1

  • Aesthetic Dentistry of Summit LLC Former legal business name

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1120176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376265600000",
    "number": "1205833498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 DEFOREST AVE",
            "address_2": "3RD FLOOR",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "07901",
            "telephone_number": "908-273-3873",
            "fax_number": "908-273-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 DEFOREST AVE",
            "address_2": "3RD FLOOR",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079011930",
            "telephone_number": "908-273-3873",
            "fax_number": "908-273-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT DENTIST",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-01",
        "last_updated": "2013-08-12",
        "status": "A",
        "authorized_official_last_name": "OK",
        "authorized_official_first_name": "MINDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-273-3873",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22-DI02025200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Aesthetic Dentistry of Summit LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Summit, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.