NPIMap

Organization Active NPI

Dental Professionals of Fair Lawn PA

  • General Practice Dentistry
  • Fair Lawn, NJ
National Provider Identifier
1275781890
Registry record updated Apr 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI01694700 Issued in NJ
Legal business name
DENTAL PROFESSIONALS OF FAIR LAWN PA
Practice address
10-06 Saddle River Rd
Fair Lawn, NJ 07410-5732
Phone
(201) 797-1555
Fax
(201) 797-1558
NPI assigned
Sep 8, 2008
Last updated
Apr 28, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2017

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

Authorized official

Name
Dr. Jody Z. Bardash, D.M.D.NPI 1972666121
Title
Dentist
Phone
(201) 797-1555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI00918500 NJ
General Practice Dentistry 1223G0001X 22DI02340000 NJ
General Practice Dentistry 1223G0001X 22DI01694700 NJ Primary

Addresses

Primary practice location

10-06 Saddle River Rd
Fair Lawn, NJ 07410-5732

Mailing address

10-06 Saddle River Rd
Fair Lawn, NJ 07410-5732
Phone (201) 797-1555

National Provider Directory

National Provider Directory

Locations

10-06 Saddle River Rd
Fair Lawn, NJ 07410
Phone (201) 797-1555

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1220832000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493337600000",
    "number": "1275781890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10-06 SADDLE RIVER RD",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074105732",
            "telephone_number": "201-797-1555",
            "fax_number": "201-797-1558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10-06 SADDLE RIVER RD",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074105732",
            "telephone_number": "201-797-1555",
            "fax_number": "201-797-1558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PROFESSIONALS OF FAIR LAWN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-08",
        "last_updated": "2017-04-28",
        "status": "A",
        "authorized_official_last_name": "BARDASH",
        "authorized_official_first_name": "JODY",
        "authorized_official_middle_name": "Z.",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "201-797-1555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI00918500",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02340000",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI01694700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 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.