River Edge Family Dental

Primary specialty

DentistTaxonomy code 122300000X

License

DI02140900 Issued in NJ

Legal business name

RIVER EDGE FAMILY DENTAL

Practice address

130 Kinderkamack Rd
Suite 303
River Edge, NJ 07661-1939

Phone

(201) 343-4044

NPI assigned

Jan 14, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Marlen Martirossian, D.D.S.

Title

President/Owner

Phone

(201) 343-4044

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1389657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389657600000",
    "number": "1346662012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 KINDERKAMACK RD",
            "address_2": "SUITE 303",
            "city": "RIVER EDGE",
            "state": "NJ",
            "postal_code": "076611939",
            "telephone_number": "201-343-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 KINDERKAMACK RD",
            "address_2": "SUITE 303",
            "city": "RIVER EDGE",
            "state": "NJ",
            "postal_code": "076611939",
            "telephone_number": "201-343-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVER EDGE FAMILY DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-14",
        "last_updated": "2014-01-14",
        "status": "A",
        "authorized_official_last_name": "MARTIROSSIAN",
        "authorized_official_first_name": "MARLEN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "201-343-4044",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI02140900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in River Edge, NJ
• Providers in River Edge, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; 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.