Midland Family Dental Care of Wyckoff, PA

Primary specialty

DentistTaxonomy code 122300000X

License

22DI01916200 Issued in NJ

Legal business name

MIDLAND FAMILY DENTAL CARE OF WYCKOFF, PA

Practice address

243 Morse Ave
Wyckoff, NJ 07481-1917

Phone

(201) 485-8848

Fax

(201) 485-8851

NPI assigned

Sep 17, 2013

Organization subpart

No

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

Authorized official

Name

Dr. Fred A Puccio, DDS

Title

President/General Dentist

Phone

(201) 206-4097

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379376000000",
    "number": "1316373756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 MORSE AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811917",
            "telephone_number": "201-485-8848",
            "fax_number": "201-485-8851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 MORSE AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811917",
            "telephone_number": "201-485-8848",
            "fax_number": "201-485-8851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDLAND FAMILY DENTAL CARE OF WYCKOFF, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-17",
        "last_updated": "2013-09-17",
        "status": "A",
        "authorized_official_last_name": "PUCCIO",
        "authorized_official_first_name": "FRED",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT/GENERAL DENTIST",
        "authorized_official_telephone_number": "201-206-4097",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI01916200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda McLachlan, MA, RD, CDN
• Kristen Megargee
• Melissa Lustmann LCSW LLC
• Christopher Mendoza, PT, DPT
• Deborah N. Michiels, BCBA
• Raymond Milazzo, DO
• Danielle Lauren Miller, MSN, FNP-BC
• David Marten Miller, R.PH.
• Stephanie Miller
• Millers of Wyckoff Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; 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.