NPIMap

Organization Active NPI

Keyport Dental Group

  • Dentist
  • Point Pleasant Boro, NJ
National Provider Identifier
1346515384
Registry record updated Mar 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DI20087 Issued in NJ
Legal business name
KEYPORT DENTAL GROUP
Practice address
2407 Bridge Ave
Point Pleasant Boro, NJ 08742-4334
Phone
(732) 714-1030
Fax
(732) 714-1142
NPI assigned
Mar 8, 2012
Last updated
Mar 8, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2012

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

Authorized official

Name
Joseph Richard Zicchino, DDSNPI 1437269271
Title
Owner
Phone
(732) 714-1030

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DI20087 NJ Primary

Addresses

Primary practice location

2407 Bridge Ave
Point Pleasant Boro, NJ 08742-4334

Mailing address

2407 Bridge Ave
Point Pleasant Boro, NJ 08742-4334
Phone (732) 714-1030

National Provider Directory

National Provider Directory

Locations

2407 Bridge Ave
Point Pleasant Boro, NJ 08742
Phone (732) 714-1030

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1331164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331164800000",
    "number": "1346515384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2407 BRIDGE AVE",
            "city": "POINT PLEASANT BORO",
            "state": "NJ",
            "postal_code": "087424334",
            "telephone_number": "732-714-1030",
            "fax_number": "732-714-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2407 BRIDGE AVE",
            "city": "POINT PLEASANT BORO",
            "state": "NJ",
            "postal_code": "087424334",
            "telephone_number": "732-714-1030",
            "fax_number": "732-714-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEYPORT DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-08",
        "last_updated": "2012-03-08",
        "status": "A",
        "authorized_official_last_name": "ZICCHINO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-714-1030",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI20087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Point Pleasant Boro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2012; 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.