Fanwood Family Dental

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02164702 Issued in NJ

Legal business name

FANWOOD FAMILY DENTAL

Practice address

225 N Martine Ave
Fanwood, NJ 07023-1336

Phone

(908) 322-7111

NPI assigned

Mar 30, 2007

Last updated

Aug 22, 2020By 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

Dr. Rushabh Shah

Title

President

Phone

(908) 322-7111

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275653388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N MARTINE AVE",
            "city": "FANWOOD",
            "state": "NJ",
            "postal_code": "070231336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N MARTINE AVE",
            "city": "FANWOOD",
            "state": "NJ",
            "postal_code": "070231336",
            "telephone_number": "908-322-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FANWOOD FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "RUSHABH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-322-7111",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02164702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• English Chiropractic, LLC
• Eric Chludzinski, PC (Fanwood Back Relief Center)
• Fanwood Dental Associates, Inc.
• Fanwood Eye Care LLC
• Fanwood Family and Cosmetic Dentistry
• Fanwood RX Corp (Fanwood Pharmacy LTC)
• Fanwood RX Corp (Fanwood Pharmacy)
• Fanwood Senior Care, LLC (The Chelsea at Fanwood)
• Jennifer C Feeney, DVM
• Theresa Fernandes, BCBA

• General Practice Dentistry in Fanwood, NJ
• Providers in Fanwood, NJ by specialty
• General Practice Dentistry in New Jersey

• 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.