Periodontal Associates of Southern New Jersey, P.C.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

PERIODONTAL ASSOCIATES OF SOUTHERN NEW JERSEY, P.C.

Practice address

100B Kings Way W
Sewell, NJ 08080-2235

Phone

(856) 589-9233

Fax

(856) 582-2439

NPI assigned

Apr 19, 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. Louis Eisenberg, D.D.S.

Title

President

Phone

(856) 589-9233

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275750135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100B KINGS WAY W",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802235",
            "telephone_number": "856-589-9233",
            "fax_number": "856-582-2439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100B KINGS WAY W",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802235",
            "telephone_number": "856-589-9233",
            "fax_number": "856-582-2439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIODONTAL ASSOCIATES OF SOUTHERN NEW JERSEY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EISENBERG",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-589-9233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Sewell, NJ
• Providers in Sewell, NJ by specialty
• Periodontics 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.