NPIMap

Organization Active NPI

Braden Dental of South Jersey PC

  • General Practice Dentistry
  • Marlton, NJ
National Provider Identifier
1295574291
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
BRADEN DENTAL OF SOUTH JERSEY PC
Practice address
100 Centre Blvd Ste J
Marlton, NJ 08053-4128
Phone
(856) 983-0060
NPI assigned
May 21, 2024
Organization subpart
Yes
Parent organization
BRADEN DENTAL OF SOUTH JERSEY PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Authorized official

Name
Douglas Sherly
Title
President
Phone
(609) 560-5902

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

100 Centre Blvd Ste J
Marlton, NJ 08053-4128

Mailing address

100 Centre Blvd Ste J
Marlton, NJ 08053-4128
Phone (856) 983-0060

Other names 1

  • Acorn Dental Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Braden Dental of South Jersey PC6 organizations share this tax ID, including this one
Part of
Braden Dental of South Jersey PC

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

100 Centre Blvd
Ste J
Marlton, NJ 08053
Phone (856) 983-0060

NPI Registry JSON

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

{
    "created_epoch": "1716249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716249600000",
    "number": "1295574291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 CENTRE BLVD STE J",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534128",
            "telephone_number": "856-983-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CENTRE BLVD STE J",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080534128",
            "telephone_number": "856-983-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADEN DENTAL OF SOUTH JERSEY PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRADEN DENTAL OF SOUTH JERSEY PC",
        "enumeration_date": "2024-05-21",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A",
        "authorized_official_last_name": "SHERLY",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-560-5902"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Acorn Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Marlton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2024; 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.