NPIMap

Organization Active NPI

American Dental Group LLC

  • General Practice Dentistry
  • Elizabeth, NJ
National Provider Identifier
1386940096
Registry record updated Jan 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02386200 Issued in NJ
Legal business name
AMERICAN DENTAL GROUP LLC
Practice address
14 Winfield Scott PLZ
Elizabeth, NJ 07201-2443
Phone
(908) 353-5400
Fax
(908) 353-7273
NPI assigned
Jan 28, 2011
Last updated
Jan 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2011

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

Authorized official

Name
Dr. Othmane Seddiki
Title
Owner
Phone
(908) 353-5400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI02386200 NJ Primary

Addresses

Primary practice location

14 Winfield Scott PLZ
Elizabeth, NJ 07201-2443

Mailing address

14 Winfield Scott PLZ
Elizabeth, NJ 07201-2443
Phone (908) 353-5400

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296172800000",
    "number": "1386940096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 WINFIELD SCOTT PLZ",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072012443",
            "telephone_number": "908-353-5400",
            "fax_number": "908-353-7273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 WINFIELD SCOTT PLZ",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072012443",
            "telephone_number": "908-353-5400",
            "fax_number": "908-353-7273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-28",
        "last_updated": "2011-01-28",
        "status": "A",
        "authorized_official_last_name": "SEDDIKI",
        "authorized_official_first_name": "OTHMANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-353-5400",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02386200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2011; 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.