Advanced Dental Group of Long Branch PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ADVANCED DENTAL GROUP OF LONG BRANCH PC

Doing business as

Jersey Shore Smiles

Practice address

107 Monmouth Rd Ste 107
West Long Branch, NJ 07764-1021

Phone

(201) 509-1032

NPI assigned

Aug 26, 2021

Last updated

Aug 26, 2021By 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

Francis Oh

Title

Owner

Phone

(201) 509-1032

Specialties & licenses 1

Addresses

Other names 1

• Jersey Shore Smiles Doing business as

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

{
    "created_epoch": "1629936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629936000000",
    "number": "1285301333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1118",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070241118",
            "telephone_number": "201-509-1032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 MONMOUTH RD STE 107",
            "city": "WEST LONG BRANCH",
            "state": "NJ",
            "postal_code": "077641021",
            "telephone_number": "201-509-1032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DENTAL GROUP OF LONG BRANCH PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-26",
        "last_updated": "2021-08-26",
        "certification_date": "2021-07-27",
        "status": "A",
        "authorized_official_last_name": "OH",
        "authorized_official_first_name": "FRANCIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-509-1032"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jersey Shore Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; 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.