Brunswick Dental Group

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02412000 Issued in NJ

Legal business name

BRUNSWICK DENTAL GROUP

Practice address

415 State Route 18
Suite 13
East Brunswick, NJ 08816-2305

Phone

(732) 955-6907

Fax

(732) 955-6837

NPI assigned

Jul 2, 2015

Last updated

Jul 2, 2015By 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. Katherine Varchenko, DMD

Title

Doctor

Phone

(732) 955-6907

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435795200000",
    "number": "1285017624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 STATE ROUTE 18",
            "address_2": "SUITE 13",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088162305",
            "telephone_number": "732-955-6907",
            "fax_number": "732-955-6837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 STATE ROUTE 18",
            "address_2": "SUITE 13",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088162305",
            "telephone_number": "732-955-6907",
            "fax_number": "732-955-6837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRUNSWICK DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-02",
        "last_updated": "2015-07-02",
        "status": "A",
        "authorized_official_last_name": "VARCHENKO",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "732-955-6907",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02412000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0235261",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0233561",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latasha Brown, NP
• Rita A Brown, LCSW, ACSW
• Saleem Brown, LSW
• Michael Benjamin Brownbridge, MSW, LSW
• Mark Brumer, PT
• Brunswick Family Dental Center
• Brunswick Medical Associates Inc
• Brunswick Medical Associates, LLC
• Brunswick Square Pharmacy
• Brunswick Surgical Ambulatory Center LLP

• Dentist in East Brunswick, NJ
• Providers in East Brunswick, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2015; 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.