Mobile Dental Practice, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI018346 Issued in NJ

Legal business name

MOBILE DENTAL PRACTICE, PC

Practice address

800 Wyckoff Ave
Suite 103
Wyckoff, NJ 07481-1525

Phone

(201) 891-4700

Fax

(201) 891-4943

NPI assigned

Dec 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Stephen A Beukas, DMDNPI 1275677213

Title

President

Phone

(201) 891-4700

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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

• Stephen A Beukas, D.M.D.

  • General Practice Dentistry
  • Wyckoff, NJ
  • NPI 1275677213
  NPD (past) Authorized official

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1235311028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WYCKOFF AVE",
            "address_2": "SUITE 103",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811525",
            "telephone_number": "201-891-4700",
            "fax_number": "201-891-4943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WYCKOFF AVE",
            "address_2": "SUITE 103",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811525",
            "telephone_number": "201-891-4700",
            "fax_number": "201-891-4943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE DENTAL PRACTICE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-03",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "BEUKAS",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-891-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI018346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0090911",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Miller
• Millers of Wyckoff Inc
• William B Milnes, PTA
• Minds Wide Open Psychotherapy, LLC
• Mlt360 Meals, Lifestyle, Nutrition Therapy, LLC
• Mondana Yazdi PA
• Bart Mongiello, LCSW
• Montenare Eye Care & Vision Therapy LLC
• Michael Thomas Montenare, O.D.
• Lisa C Monti, R.D., M.S.

• General Practice Dentistry in Wyckoff, NJ
• Providers in Wyckoff, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.