Organization Active NPI

Community Dental of Pemberton, P.C.

  • General Practice Dentistry
  • Browns Mills, NJ
National Provider Identifier
1366337842
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
COMMUNITY DENTAL OF PEMBERTON, P.C.
Practice address
18 Broadway Street
Browns Mills, NJ 08015
Phone
(609) 997-2929
NPI assigned
Jun 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Authorized official

Name
Dr. Glenn Prager, DDS
Title
Owner
Phone
(917) 751-8117

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

18 Broadway Street
Browns Mills, NJ 08015

Mailing address

109 Galestown Circle
Chesterfield, NJ 08515
Phone (215) 962-5668

National Provider Directory

National Provider Directory

Locations

18 Broadway
Browns Mills, NJ 08015
Phone (609) 735-1540

NPI Registry JSON

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

{
    "created_epoch": "1749686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749686400000",
    "number": "1366337842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 GALESTOWN CIRCLE",
            "city": "CHESTERFIELD",
            "state": "NJ",
            "postal_code": "08515",
            "telephone_number": "215-962-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 BROADWAY STREET",
            "city": "BROWNS MILLS",
            "state": "NJ",
            "postal_code": "08015",
            "telephone_number": "609-997-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY DENTAL OF PEMBERTON, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-12",
        "last_updated": "2025-06-12",
        "status": "A",
        "authorized_official_last_name": "PRAGER",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-751-8117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Browns Mills, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2025; 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.