Bloomfield Ave Dental Spec, LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

BLOOMFIELD AVE DENTAL SPEC, LLC

Practice address

223 Bloomfield Ave Ste 2
Newark, NJ 07104-1104

Phone

(973) 435-8100

NPI assigned

Sep 6, 2022

Organization subpart

No

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

Authorized official

Name

Michael E Skolnick, DMD

Title

President

Phone

(973) 435-8100

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1662422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680134400000",
    "number": "1306567656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 BLOOMFIELD AVE STE 2",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071041104",
            "telephone_number": "973-435-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 BLOOMFIELD AVE STE 2",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071041104",
            "telephone_number": "973-435-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMFIELD AVE DENTAL SPEC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-06",
        "last_updated": "2023-03-30",
        "certification_date": "2023-03-30",
        "status": "A",
        "authorized_official_last_name": "SKOLNICK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-435-8100",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://childsmiles.com/",
            "affiliation": "N",
            "address_1": "223 Bloomfield Ave Ste 2",
            "city": "Newark",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "071041104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Blessed Healthcare Services
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• Nikolas Anthony Bletnitsky
• Sergey Blintsovskiy, MD
• Samantha Block, MD
• Bloomfield Ave Dental, LLC
• Bloomfield Health Pavilion LLC
• Bloomfield Hospital Physicians, P.a.
• Blue Aid Home Care LLC
• Blue Medical Diagnostics East

• Dentist in Newark, NJ
• Providers in Newark, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2023; 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.