New Jersey Dental Associate

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

22DI02128400 Issued in NJ

Legal business name

NEW JERSEY DENTAL ASSOCIATE

Practice address

1355 15TH St
Fort Lee, NJ 07024-2039

Phone

(201) 585-8585

NPI assigned

Nov 30, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Khaled Eldin, DDS

Title

Owner

Phone

(201) 585-8585

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1215441142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 15TH ST",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070242039",
            "telephone_number": "201-585-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 15TH ST",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070242039",
            "telephone_number": "201-585-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW JERSEY DENTAL ASSOCIATE",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-30",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "ELDIN",
        "authorized_official_first_name": "KHALED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-585-8585",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NJ",
            "license": "22DI02128400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Dental Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.