Patricia L. Bastidas, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DI-018241 Issued in NJ

Practice address

904 Pompton Ave
Suite a-1
Cedar Grove, NJ 07009-1262

Phone

(973) 857-0222

Fax

(973) 857-9508

NPI assigned

Mar 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bastidas Family Dentistry, PA

  • Dentist
  • Cedar Grove, NJ
  • NPI 1649394230
  NPD (past) Authorized official
• Smiles at Cedar Grove PC

  • Dental Clinic/Center
  • Cedar Grove, NJ
  • NPI 1902766132
  NPD (past)

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1386768059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 POMPTON AVE",
            "address_2": "SUITE A-1",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091262",
            "telephone_number": "973-857-0222",
            "fax_number": "973-857-9508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 POMPTON AVE",
            "address_2": "SUITE A-1",
            "city": "CEDAR GROVE",
            "state": "NJ",
            "postal_code": "070091262",
            "telephone_number": "973-857-0222",
            "fax_number": "973-857-9508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASTIDAS",
        "first_name": "PATRICIA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI-018241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Balanced Body Acupuncture, LLC
• Agnieszka Baranowska, PTA
• Peter S Barnett, PT, DPT, OCS
• Bastidas Family Dentistry, PA
• Jorge A. Bastidas, DMD
• Behavior Plus Therapies, LLC
• Dona M Bellucci, PHD
• Anthony Clayton Berlet, M.D.
• Radha Bhatia, PH.D.
• Jessica L. Blum, PT

• Dentist in Cedar Grove, NJ
• Providers in Cedar Grove, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.