Dentart of Paramus

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

22DI01990900 Issued in NJ

Legal business name

DENTART OF PARAMUS

Practice address

501 N Rte 17
Paramus, NJ 07652-3000

Phone

(201) 497-1666

Fax

(201) 497-1667

NPI assigned

Apr 4, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Dmitry Stillman, DDS

Title

Owner

Phone

(201) 497-1666

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dental Health 360 Doing business as

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491264000000",
    "number": "1265965636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 N RTE 17",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523000",
            "telephone_number": "201-497-1666",
            "fax_number": "201-497-1667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 N RTE 17",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076523000",
            "telephone_number": "201-497-1666",
            "fax_number": "201-497-1667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTART OF PARAMUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-04",
        "last_updated": "2017-04-04",
        "status": "A",
        "authorized_official_last_name": "STILLMAN",
        "authorized_official_first_name": "DMITRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-497-1666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI01990900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0137375",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Health 360",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Alexandria Deptuch, LSW
• Anna Derbaly-Basenese, PSYD

• Pediatric Dentistry in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; 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.