Family and Cosmetic Dentistry,DRS. Stanislaus and Michelotti

Primary specialty

DentistTaxonomy code 122300000X

License

22DI01718000 Issued in NJ

Legal business name

FAMILY AND COSMETIC DENTISTRY,DRS. STANISLAUS AND MICHELOTTI

Practice address

4249 US Highway 9
Building 2, Suite a
Freehold, NJ 07728-8308

Phone

(732) 409-0330

Fax

(732) 409-0353

NPI assigned

May 7, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Glenn Raj Stanislaus, DMD

Title

Partner

Phone

(732) 409-0330

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407069693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4249 US HIGHWAY 9",
            "address_2": "BUILDING 2, SUITE A",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077288308",
            "telephone_number": "732-409-0330",
            "fax_number": "732-409-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4249 US HIGHWAY 9",
            "address_2": "BUILDING 2, SUITE A",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077288308",
            "telephone_number": "732-409-0330",
            "fax_number": "732-409-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY AND COSMETIC DENTISTRY,DRS. STANISLAUS AND MICHELOTTI",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STANISLAUS",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "RAJ",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "732-409-0330",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI01718000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Freehold, NJ
• Providers in Freehold, NJ by specialty
• Dentist 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.