NPIMap

Organization Active NPI

Dental Care of Stratford

  • General Practice Dentistry
  • Stratford, NJ
National Provider Identifier
1265644322
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
018248 Issued in NJ
Legal business name
DENTAL CARE OF STRATFORD
Practice address
105 E Laurel Rd
Stratford, NJ 08084-1324
Phone
(856) 783-6100
Fax
(856) 309-0956
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Frank Pettisani Jr., DMD
Title
Owner
Phone
(856) 783-6100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 018248 NJ Primary

Addresses

Primary practice location

105 E Laurel Rd
Stratford, NJ 08084-1324

Mailing address

105 E Laurel Rd
Stratford, NJ 08084-1324
Phone (856) 783-6100

National Provider Directory

National Provider Directory

Locations

105 E Laurel Rd
Stratford, NJ 08084
Phone (856) 783-6100

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": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1265644322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 E LAUREL RD",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841324",
            "telephone_number": "856-783-6100",
            "fax_number": "856-309-0956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 E LAUREL RD",
            "city": "STRATFORD",
            "state": "NJ",
            "postal_code": "080841324",
            "telephone_number": "856-783-6100",
            "fax_number": "856-309-0956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL CARE OF STRATFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETTISANI",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-783-6100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "018248",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stratford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.