Old Bridge Dental Center

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

Organization subpart

No

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

Authorized official

Name

Dr. Khaled Eldin, DDS

Title

President

Phone

(732) 679-6666

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER ID FOR DORAL",
            "identifier": "9179242",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan Okun, MD
• Old Bridge Center of Physical Therapy Inc
• Old Bridge Dental Arts
• Old Bridge Dental Arts
• Old Bridge Dental Care
• Old Bridge Dental Practice LLC
• Old Bridge Drugs and Surgicals LLC
• Old Bridge Family Eyecare LLC
• Old Bridge Family Orthodontics LLC
• Old Bridge First Aid and Rescue Squad of Madison Township Inc

• Dentist in Old Bridge, NJ
• Providers in Old Bridge, 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.