Organization Active NPI

Riverside Oral Surgery - Warren

  • Oral and Maxillofacial Surgery (Dentist)
  • Warren, NJ
National Provider Identifier
1356080170
Registry record updated May 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
Legal business name
RIVERSIDE ORAL SURGERY - WARREN
Practice address
65 Mountain Blvd Ext Ste 106
Warren, NJ 07059-5658
Phone
(732) 356-1414
NPI assigned
May 31, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2022

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

Authorized official

Name
Dr. Jason M Auerabach, DDS
Title
Owner
Phone
(201) 487-6565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X Primary

Addresses

Primary practice location

65 Mountain Blvd Ext Ste 106
Warren, NJ 07059-5658

Mailing address

130 Kinderkamack Rd Ste 204
River Edge, NJ 07661-1931
Phone (201) 487-6565

Other names 1

  • James McMenamin, DDS Former legal business name

National Provider Directory

National Provider Directory

Locations

65 Mountain Blvd Ext
Ste 106
Warren, NJ 07059
Phone (732) 356-1414

Practitioners & affiliated clinicians

Practitioners 1

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": "1653955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653955200000",
    "number": "1356080170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 KINDERKAMACK RD STE 204",
            "city": "RIVER EDGE",
            "state": "NJ",
            "postal_code": "076611931",
            "telephone_number": "201-487-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 MOUNTAIN BLVD EXT STE 106",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070595658",
            "telephone_number": "732-356-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE ORAL SURGERY - WARREN",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-31",
        "last_updated": "2022-05-31",
        "certification_date": "2022-05-31",
        "status": "A",
        "authorized_official_last_name": "AUERABACH",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-487-6565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "James McMenamin, DDS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Warren, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.