Rutgers School of Dental Medicine

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

RUTGERS SCHOOL OF DENTAL MEDICINE

Doing business as

University John H. Cronin Dental Center

Practice address

235 Dolphin Ave
Northfield, NJ 08225-2015

Phone

(609) 645-5814

Fax

(609) 645-5872

NPI assigned

May 8, 2007

Last updated

May 9, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David Bolger, DMD

Title

Code Director

Phone

(609) 645-5814

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• University John H. Cronin Dental Center Doing business as

Tax ID family

Division of Oral Medicine3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Rutgers School of Dental Medicine

  • Dental Clinic/Center
  • Newark, NJ
  • NPI 1073712543
  NPD tax ID
• Rutgers School of Dental Medicine

  dba University Dental Center at Somerdale

  • Dental Clinic/Center
  • Somerdale, NJ
  • NPI 1831302504
  NPD tax ID

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399593600000",
    "number": "1407069107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BERGEN ST",
            "address_2": "RSDM ROOM D-954",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 DOLPHIN AVE",
            "city": "NORTHFIELD",
            "state": "NJ",
            "postal_code": "082252015",
            "telephone_number": "609-645-5814",
            "fax_number": "609-645-5872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTGERS SCHOOL OF DENTAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2014-05-09",
        "status": "A",
        "authorized_official_last_name": "BOLGER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CODE DIRECTOR",
        "authorized_official_telephone_number": "609-645-5814",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018384",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "University John H. Cronin Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Robert Pasahow, PHD, LLC
• Rodney C. Brunson, DO PC (Trauma Case Research & Management)
• Ana R Rodriguez, LCSW
• Marlene V Rodriguez, MD
• Glorymar Rosario, CMA
• Tyler Rzemyk, PT
• S & H Rehabilitation Associates, LLC (Integrity Physical Therapy Wellness)
• Spencer Carl Saint-Cyr, DMD
• Joann Sampolski, APN
• Samantha Anne Sampson

• Dental Clinic/Center in Northfield, NJ
• Providers in Northfield, NJ by specialty
• Dental Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2014; 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.