Prism Oral Surgery & Implants of Summit

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

Legal business name

PRISM ORAL SURGERY & IMPLANTS OF SUMMIT

Practice address

55 Woodland Ave
Summit, NJ 07901-2225

Phone

(201) 741-2217

NPI assigned

Feb 17, 2025

Last updated

Feb 17, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jean Kim Lau, DDSNPI 1730563107

Title

Ceo, Surgeon

Phone

(201) 741-2217

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, and the practitioner matching its NPPES authorized official.

• Jean Kim Lau, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Summit, NJ
  • NPI 1730563107

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1739750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1265237069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WOODLAND AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079012225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WOODLAND AVE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079012225",
            "telephone_number": "201-741-2217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISM ORAL SURGERY & IMPLANTS OF SUMMIT",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-17",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-16",
        "status": "A",
        "authorized_official_last_name": "LAU",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "KIM",
        "authorized_official_title_or_position": "CEO, SURGEON",
        "authorized_official_telephone_number": "201-741-2217",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Brooke Pozner, MD
• Beverly Pranzatelli, P.T.
• Premier Health of Summit LLC
• Mikel Jadyne Pride, D.O.
• Primary Care Associates
• Bryan I. Proano Redmond, LCSW
• Professional Occupational & Physical Therapy, PLLC
• Professional Orthopedic and Sports Physical Therapy of NJ, LLC
• Susan B Profeta, M.D.
• Matthew Chae Hamilton Proute, M.B.B.S.

• Oral & Maxillofacial Surgery (D.M.D.) in Summit, NJ
• Providers in Summit, NJ by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.