Smilist Dental of New Jersey LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02564700 Issued in NJ

Legal business name

SMILIST DENTAL OF NEW JERSEY LLC

Practice address

305 South Ave
Garwood, NJ 07027-1343

Phone

(516) 439-4756

NPI assigned

Oct 4, 2017

Organization subpart

No

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

Authorized official

Name

Jay Khorsandi, DDS

Title

Member

Phone

(516) 439-4756

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1507075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507075200000",
    "number": "1376053389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CUTTERMILL RD STE 400",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 SOUTH AVE",
            "city": "GARWOOD",
            "state": "NJ",
            "postal_code": "070271343",
            "telephone_number": "516-439-4756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILIST DENTAL OF NEW JERSEY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-04",
        "last_updated": "2017-10-04",
        "status": "A",
        "authorized_official_last_name": "KHORSANDI",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "516-439-4756",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02564700",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02564700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Breyn R Peters-Schuster, D.D.S., M.S.D
• Gabriella Porter, MSN, FNP-BC
• Leonardo A Ramos
• Craig Rosenthal, DDS
• RWJ Rahway Carecenter, LLC
• Kaisa Stroher
• Kamini Tailor, OD
• Tamav Irini Inc
• Tamav Irini Inc
• Hok Chun Tang, PHARMD

• General Practice Dentistry in Garwood, NJ
• Providers in Garwood, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.