Organization Active NPI

Kelner Periodontics

  • Dentist
  • Clark, NJ
National Provider Identifier
1396096855
Registry record updated Sep 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22D102321200 Issued in NJ
Legal business name
KELNER PERIODONTICS
Practice address
1119 Raritan Rd
Clark, NJ 07066
Phone
(908) 753-4427
Fax
(908) 756-7019
NPI assigned
Sep 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2012

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

Authorized official

Name
Danielle B. Kelner, D.M.D
Title
Owner
Phone
(732) 382-9090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 22D102321200 NJ Primary

Addresses

Primary practice location

1119 Raritan Rd
Clark, NJ 07066

Mailing address

1119 Raritan Rd
Clark, NJ 07066
Phone (732) 382-9090

National Provider Directory

National Provider Directory
Tax ID family
Kelner Periodontics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1119 Raritan Rd
Clark, NJ 07066
Phone (732) 396-1881

NPI Registry JSON

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

{
    "created_epoch": "1348531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348531200000",
    "number": "1396096855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 RARITAN RD",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "07066",
            "telephone_number": "732-382-9090",
            "fax_number": "732-396-1527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 RARITAN RD",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "07066",
            "telephone_number": "908-753-4427",
            "fax_number": "908-756-7019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELNER PERIODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-25",
        "last_updated": "2012-09-25",
        "status": "A",
        "authorized_official_last_name": "KELNER",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-382-9090",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22D102321200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; 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.