Supreme Dental Associates, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02143500 Issued in NJ

Legal business name

SUPREME DENTAL ASSOCIATES, LLC

Practice address

331 Valley Rd
West Orange, NJ 07052-5302

Phone

(973) 325-9800

Fax

(973) 325-9877

NPI assigned

Jan 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Bedes Osuala, D.M.D.NPI 1437206067

Title

Owner Administrator

Phone

(973) 325-9800

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Bedes Osuala, D.M.D.

  • General Practice Dentistry
  • West Orange, NJ
  • NPI 1437206067

  General Practice

  NPD (past) Authorized official
• Rene Osuala, DMD

  • Dentist
  • West Orange, NJ
  • NPI 1346589124
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386795409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 VALLEY RD",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070525302",
            "telephone_number": "973-325-9800",
            "fax_number": "973-325-9877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 VALLEY RD",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070525302",
            "telephone_number": "973-325-9800",
            "fax_number": "973-325-9877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUPREME DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "OSUALA",
        "authorized_official_first_name": "BEDES",
        "authorized_official_title_or_position": "OWNER ADMINISTRATOR",
        "authorized_official_telephone_number": "973-325-9800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02143500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in West Orange, NJ
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.