Organization Active NPI

Pediatric Dentistry and Orthodontics Center LLC

  • Dentist
  • Midland Park, NJ
National Provider Identifier
1255995502
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
PEDIATRIC DENTISTRY AND ORTHODONTICS CENTER LLC
Practice address
6 Prospect St Ste 1a
Midland Park, NJ 07432-1606
Phone
(201) 445-5555
Fax
(201) 445-5057
NPI assigned
Apr 23, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Authorized official

Name
Victoria Johnson
Title
Cro
Phone
(941) 444-0558

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

6 Prospect St Ste 1a
Midland Park, NJ 07432-1606

Mailing address

6 Prospect St Ste 1a
Midland Park, NJ 07432-1606
Phone (201) 445-5555

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784592000000",
    "number": "1255995502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 PROSPECT ST STE 1A",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321606",
            "telephone_number": "201-445-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PROSPECT ST STE 1A",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321606",
            "telephone_number": "201-445-5555",
            "fax_number": "201-445-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTISTRY AND ORTHODONTICS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-23",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "CRO",
        "authorized_official_telephone_number": "941-444-0558"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; 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.