NPIMap

Organization Active NPI

Rutgers School of Dental Medicine

  • Dental Clinic/Center
  • Newark, NJ
National Provider Identifier
1487853248
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
RUTGERS SCHOOL OF DENTAL MEDICINE
Practice address
110 Bergen St
Newark, NJ 07103-2495
Phone
(973) 973-8668
NPI assigned
Jul 12, 2007
Last updated
Jun 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

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

Authorized official

Name
Rosemarie Vaccaro
Title
Sr MGR Billing & Collections Office
Phone
(973) 972-4633

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary

Addresses

Primary practice location

110 Bergen St
Newark, NJ 07103-2495

Mailing address

110 Bergen Street
B842A
Newark, NJ 07103-2495
Phone (973) 972-4242

Other identifiers 1

IdentifierTypeStateIssuer
0018309-01MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
Rutgers Univ Dental Assocs2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

110 Bergen St
#B842A
Newark, NJ 07103

110 Bergen St
Rm D718
Newark, NJ 07103
Phone (973) 972-1606

Practitioners & affiliated clinicians

Practitioners 31

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.

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1184198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717632000000",
    "number": "1487853248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BERGEN STREET",
            "address_2": "B842A",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032495",
            "telephone_number": "973-972-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032495",
            "telephone_number": "973-973-8668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUTGERS SCHOOL OF DENTAL MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-12",
        "last_updated": "2024-06-06",
        "status": "A",
        "authorized_official_last_name": "VACCARO",
        "authorized_official_first_name": "ROSEMARIE",
        "authorized_official_title_or_position": "SR MGR BILLING & COLLECTIONS OFFICE",
        "authorized_official_telephone_number": "973-972-4633"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018309-01",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.