NPIMap

Organization Active NPI

Periollp

  • Periodontics
  • Nutley, NJ
National Provider Identifier
1346541885
Registry record updated Nov 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DI18768 Issued in NJ
Legal business name
PERIOLLP
Practice address
230 Centre Street
Nutley, NJ 07110
Phone
(973) 661-2992
Fax
(973) 661-3513
NPI assigned
Nov 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2010

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

Authorized official

Name
Cortney Stuart
Title
Office Manager
Phone
(973) 661-2992

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X DI18768 NJ Primary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X DI 20033 NJ

Addresses

Primary practice location

230 Centre Street
Nutley, NJ 07110

Mailing address

230 Centre Street
Nutley, NJ 07110
Phone (973) 661-2992

Other names 1

  • Advanced Periodontics Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289865600000",
    "number": "1346541885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 CENTRE STREET",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "07110",
            "telephone_number": "973-661-2992",
            "fax_number": "973-661-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 CENTRE STREET",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "07110",
            "telephone_number": "973-661-2992",
            "fax_number": "973-661-3513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIOLLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2010-11-16",
        "status": "A",
        "authorized_official_last_name": "STUART",
        "authorized_official_first_name": "CORTNEY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "973-661-2992"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "DI18768",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "DI 20033",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Periodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Nutley, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.