Monmouth County Periodontics LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

MONMOUTH COUNTY PERIODONTICS LLC

Doing business as

Monmouth Periodontics & Implant Dentistry

Practice address

193 US Highway 9 Ste 2C
Manalapan, NJ 07726-3016

Phone

(732) 409-2900

Fax

(732) 409-6524

NPI assigned

Feb 14, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Andres Jimenez Wolf, DDS, MSDNPI 1124410741

Title

Owner

Phone

(732) 409-2900

Specialties & licenses 2

Addresses

Other names 1

• Monmouth Periodontics & Implant Dentistry Doing business as

Locations

Practitioners 3

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

• Andres Jimenez Wolf, DDS, MSD

  • Periodontics
  • Manalapan, NJ
  • NPI 1124410741
  NPD Authorized official
• Leslie Ann Furie, DDS

  • Periodontics
  • Manalapan, NJ
  • NPI 1699835553
  NPD (past)
• Cecilia Amarantha White, DMD

  • General Practice Dentistry
  • Princeton, NJ
  • NPI 1528611944
  NPD (past)

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

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644796800000",
    "number": "1346995834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 US HIGHWAY 9 STE 2C",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077263016",
            "telephone_number": "732-409-2900",
            "fax_number": "732-409-6524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 US HIGHWAY 9 STE 2C",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077263016",
            "telephone_number": "732-409-2900",
            "fax_number": "732-409-6524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONMOUTH COUNTY PERIODONTICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-14",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A",
        "authorized_official_last_name": "JIMENEZ WOLF",
        "authorized_official_first_name": "ANDRES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-409-2900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MSD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Monmouth Periodontics & Implant Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Monmouth Back & Neck Rehabilitation LLC
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• Monmouth Diagnostics, P.C.
• Monmouth Speech & Cognition
• Monmouth Spine and Wellness LLC
• Beverly Moore-Clark
• David Moran, DMD

• Periodontics in Manalapan, NJ
• Providers in Manalapan, NJ by specialty
• Periodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2022; 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.