Paterson Dental Clinic

Primary specialty

DentistTaxonomy code 122300000X

License

DI19009 Issued in NJ

Legal business name

PATERSON DENTAL CLINIC

Practice address

294 Broadway
Paterson, NJ 07501-2030

Phone

(973) 684-5854

Fax

(973) 684-1952

NPI assigned

May 9, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Faizul T Khan, DDS

Title

President

Phone

(973) 684-5854

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1368057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368057600000",
    "number": "1235574872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "294 BROADWAY",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075012030",
            "telephone_number": "973-684-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "294 BROADWAY",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075012030",
            "telephone_number": "973-684-5854",
            "fax_number": "973-684-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATERSON DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-09",
        "last_updated": "2013-05-09",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "FAIZUL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-684-5854",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI19009",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7093900-01",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paterson Community Health Center, Inc.
• Paterson Community Health Center, Inc.
• Paterson Community Health Center, Inc.
• Paterson Counseling Center
• Paterson Counseling Center, Inc.
• Paterson Dental Group PA
• Paterson Dental Spec, LLC
• Paterson Dental, LLC
• Paterson Division of Health
• Paterson Division of Health

• Dentist in Paterson, NJ
• Providers in Paterson, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 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.