Little Smiles Pediatric Dentistry of South Jersey

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

LITTLE SMILES PEDIATRIC DENTISTRY OF SOUTH JERSEY

Doing business as

Little Smiles

Practice address

1206 W Sherman Ave Ste 4D
Vineland, NJ 08360-6911

Phone

(856) 368-2800

Fax

(856) 412-5100

NPI assigned

May 1, 2024

Organization subpart

No

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

Authorized official

Name

Darlene L Mander

Title

Credentialing/Ar

Phone

(856) 207-8406

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Little Smiles Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Prasanthi Bobba, D.D.S

  • Pediatric Dentistry
  • Vineland, NJ
  • NPI 1013223999
  NPD

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

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1295582005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 W SHERMAN AVE STE 4D",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606911",
            "telephone_number": "856-368-2800",
            "fax_number": "856-412-5100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 W SHERMAN AVE STE 4D",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606911",
            "telephone_number": "856-368-2800",
            "fax_number": "856-412-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE SMILES PEDIATRIC DENTISTRY OF SOUTH JERSEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "MANDER",
        "authorized_official_first_name": "DARLENE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CREDENTIALING/AR",
        "authorized_official_telephone_number": "856-207-8406"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SPECIALTY PERMIT",
            "identifier": "06371-03",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0490644",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "22DI02457700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Little Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Steven Craig Linn, MD
• Emilie R Linzan
• Ashley Lauren Lippincott, CRNA
• Jordan Lipschutz, MD
• Trina Marie Lisko, DO
• Andrew K Liu, M.D.
• Charles Liu, D.D.S
• Stephanie Liu
• Liv Again Wellness
• Iyana S Livingston

• Pediatric Dentistry in Vineland, NJ
• Providers in Vineland, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.