Prime Care Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

PRIME CARE DENTAL LLC

Practice address

1 Washington Blvd Ste 8
Robbinsville, NJ 08691-3162

Phone

(609) 490-1616

NPI assigned

Mar 7, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Keyur Modi, DMDNPI 1255869616

Title

Owner Dentist

Phone

(201) 755-1525

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 3

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

• Keyur Modi

  • General Practice Dentistry
  • Robbinsville, NJ
  • NPI 1255869616
  NPD Authorized official
• Brian Eustace Ferry, D.M.D.

  • General Practice Dentistry
  • Robbinsville, NJ
  • NPI 1801948047
  NPD (past)
• Mont Ray Jose Holgado, D.M.D.

  • Dentist
  • Robbinsville, NJ
  • NPI 1104979103
  NPD (past)

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

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1427758564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WASHINGTON BLVD STE 8",
            "city": "ROBBINSVILLE",
            "state": "NJ",
            "postal_code": "086913162",
            "telephone_number": "609-490-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WASHINGTON BLVD STE 8",
            "city": "ROBBINSVILLE",
            "state": "NJ",
            "postal_code": "086913162",
            "telephone_number": "609-490-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME CARE DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-07",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "MODI",
        "authorized_official_first_name": "KEYUR",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "201-755-1525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTIST",
            "identifier": "22DI02686700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Petrie
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• Amanda Pownall
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• Jodi Noel Pultorak, LCSW
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• Ashley Rallis

• General Practice Dentistry in Robbinsville, NJ
• Providers in Robbinsville, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.