Organization Active NPI

Old Bridge Dental Center

  • Dentist
  • Old Bridge, NJ
National Provider Identifier
1487736740
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DI 21284 Issued in NJ
Legal business name
OLD BRIDGE DENTAL CENTER
Practice address
3333 US Highway 9
Old Bridge, NJ 08857-2691
Phone
(732) 679-6666
Fax
(732) 679-6676
NPI assigned
Oct 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Khaled Eldin, DDSNPI 1720143415
Title
President
Phone
(732) 679-6666

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DI 21284 NJ Primary

Addresses

Primary practice location

3333 US Highway 9
Old Bridge, NJ 08857-2691

Mailing address

3333 US Highway 9
Old Bridge, NJ 08857-2691
Phone (732) 679-6666

National Provider Directory

National Provider Directory

Locations

3333 US Highway 9
Old Bridge, NJ 08857
Phone (732) 679-6666

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1487736740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 US HIGHWAY 9",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572691",
            "telephone_number": "732-679-6666",
            "fax_number": "732-679-6676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 US HIGHWAY 9",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572691",
            "telephone_number": "732-679-6666",
            "fax_number": "732-679-6676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD BRIDGE DENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELDIN",
        "authorized_official_first_name": "KHALED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-679-6666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI 21284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

  • 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.