Garden State Orofacial Pain LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

DI24531 Issued in NJ

Legal business name

GARDEN STATE OROFACIAL PAIN LLC

Practice address

258 Broad St
Red Bank, NJ 07701-2035

Phone

(732) 345-1800

NPI assigned

Jul 14, 2016

Last updated

Jul 14, 2016By 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. Sowmya Ananthan, DMD, MSD

Title

Member

Phone

(732) 345-1800

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1468454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468454400000",
    "number": "1477906592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 RENOIR DR",
            "city": "MONMOUTH JUNCTION",
            "state": "NJ",
            "postal_code": "088522543",
            "telephone_number": "732-345-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 BROAD ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077012035",
            "telephone_number": "732-345-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN STATE OROFACIAL PAIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-14",
        "last_updated": "2016-07-14",
        "status": "A",
        "authorized_official_last_name": "ANANTHAN",
        "authorized_official_first_name": "SOWMYA",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "732-345-1800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MSD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NJ",
            "license": "DI24531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Gallagher, M.S., R.D.
• Gallardo Medical
• Mary Catherine Gambarony
• Jennifer Karen Gambino
• Magdalena Maria Gapinski, MD
• Garnet Pediatric Therapy, LLC
• Marie A. Garon, PMHNP-BC
• Veronica D Garzon-Kashani, PA-C
• Danielle Gasperini, LCSW
• Mark Joel Gelband, D.D.S.

• Dental Clinic/Center in Red Bank, NJ
• Providers in Red Bank, 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 Jul 14, 2016; 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.