A Beautiful Smile Dentistry, L.L.C.

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

A BEAUTIFUL SMILE DENTISTRY, L.L.C.

Practice address

1315 Anderson Ave
Ste a
Fort Lee, NJ 07024-1732

Phone

(201) 224-4400

Fax

(201) 224-4418

NPI assigned

May 24, 2005

Organization subpart

No

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

Authorized official

Name

David Jin, DDS

Title

Owner

Phone

(201) 224-4400

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1728432000000",
    "number": "1316940224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 ANDERSON AVE",
            "address_2": "STE A",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070241732",
            "telephone_number": "201-224-4400",
            "fax_number": "201-224-4418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 ANDERSON AVE",
            "address_2": "STE A",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070241732",
            "telephone_number": "201-224-4400",
            "fax_number": "201-224-4418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A BEAUTIFUL SMILE DENTISTRY, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-24",
        "last_updated": "2024-10-09",
        "certification_date": "2024-10-09",
        "status": "A",
        "authorized_official_last_name": "JIN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-224-4400",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02183600",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "047558-1",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Multi-Specialty Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 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.