First Mountain Dental Group P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI01960400 Issued in NJ

Legal business name

FIRST MOUNTAIN DENTAL GROUP P.C.

Practice address

31 S Fullerton Ave
Suite a
Montclair, NJ 07042-3455

Phone

(973) 746-7771

Fax

(973) 746-2177

NPI assigned

Mar 25, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Konstantine Trichas, DDSNPI 1437198827

Title

President

Phone

(973) 746-7771

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Konstantine Trichas

  • General Practice Dentistry
  • Montclair, NJ
  • NPI 1437198827
  NPD (past) Authorized official

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

{
    "created_epoch": "1174780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440979200000",
    "number": "1477670206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 S FULLERTON AVE",
            "address_2": "SUITE A",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423455",
            "telephone_number": "973-746-7771",
            "fax_number": "973-746-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 S FULLERTON AVE",
            "address_2": "SUITE A",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070423455",
            "telephone_number": "973-746-7771",
            "fax_number": "973-746-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST MOUNTAIN DENTAL GROUP P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-25",
        "last_updated": "2015-08-31",
        "status": "A",
        "authorized_official_last_name": "TRICHAS",
        "authorized_official_first_name": "KONSTANTINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-746-7771",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI01960400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Montclair, NJ
• Providers in Montclair, 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 Aug 31, 2015; 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.