Implant & Dental Center of NJ PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

02028800 Issued in NJ

Legal business name

IMPLANT & DENTAL CENTER OF NJ PC

Practice address

6815 Bergenline Ave
Guttenberg, NJ 07093-1807

Phone

(201) 868-0808

NPI assigned

May 20, 2014

Organization subpart

No

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

Authorized official

Name

Dr. David Lac, DDSNPI 1972640613

Title

Owner

Phone

(201) 868-0808

Specialties & licenses 1

Addresses

Practitioners 1

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

• David Lac, D.D.S.

  • General Practice Dentistry
  • Kearny, NJ
  • NPI 1972640613
  NPD (past) Authorized official

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

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400544000000",
    "number": "1235540667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 KEARNY AVE",
            "city": "KEARNY",
            "state": "NJ",
            "postal_code": "070322372",
            "telephone_number": "201-868-0808",
            "fax_number": "201-955-2651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6815 BERGENLINE AVE",
            "city": "GUTTENBERG",
            "state": "NJ",
            "postal_code": "070931807",
            "telephone_number": "201-868-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPLANT & DENTAL CENTER OF NJ PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-20",
        "last_updated": "2014-05-20",
        "status": "A",
        "authorized_official_last_name": "LAC",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-868-0808",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "02028800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Guttenberg, NJ
• Providers in Guttenberg, 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 May 20, 2014; 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.