St Michael Dental Clinic Corporation

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

22DI02492200 Issued in NJ

Legal business name

ST MICHAEL DENTAL CLINIC CORPORATION

Practice address

664 Broadway
Bayonne, NJ 07002-4726

Phone

(201) 823-2062

Fax

(201) 858-8696

NPI assigned

Mar 22, 2013

Organization subpart

No

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

Authorized official

Name

Olivia Yanni, D.M.D.NPI 1073888715

Title

President

Phone

(201) 993-9181

Specialties & licenses 1

Addresses

Practitioners 1

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

• Olivia Yanni, DMD

  • General Practice Dentistry
  • Bayonne, NJ
  • NPI 1073888715
  NPD (past) Authorized official

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

{
    "created_epoch": "1363910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363910400000",
    "number": "1487996997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "664 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070024726",
            "telephone_number": "201-823-2062",
            "fax_number": "201-858-8696"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "664 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070024726",
            "telephone_number": "201-823-2062",
            "fax_number": "201-858-8696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST MICHAEL DENTAL CLINIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-22",
        "last_updated": "2013-03-22",
        "status": "A",
        "authorized_official_last_name": "YANNI",
        "authorized_official_first_name": "OLIVIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-993-9181",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Dental Public Health",
            "state": "NJ",
            "license": "22DI02492200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SRVN Pharmacy Inc
• St Ann Ortho Fitting LLC
• St George Clinic, Inc.
• St Maria Pharmacy
• St Marina Pharmacy Inc
• St Thomas Mediccal Center
• St. Anthony Medical Lab
• Stat Medical Services
• Stat Medical Services LLC
• Steady Minds

• Public Health Dentistry in Bayonne, NJ
• Providers in Bayonne, NJ by specialty
• Public Health Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; 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.