NPIMap

Organization Active NPI

Eastern Dental of Lawrenceville, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Lawrenceville, NJ
National Provider Identifier
1497803597
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
10967 Issued in NJ
Legal business name
EASTERN DENTAL OF LAWRENCEVILLE, LLC
Practice address
520 Lawrence Square Blvd S
Lawrenceville, NJ 08648-2674
Phone
(609) 587-6300
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Dr. Manish Mistry, D.D.SNPI 1881720043
Title
Director
Phone
(609) 587-6300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 19184 NJ
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X 10967 NJ Primary

Addresses

Primary practice location

520 Lawrence Square Blvd S
Lawrenceville, NJ 08648-2674

Mailing address

1030 Saint Georges Ave
Avenel, NJ 07001-1390

National Provider Directory

National Provider Directory

Locations

520 Lawrence Square Blvd S
Lawrenceville, NJ 08648
Phone (609) 587-6300

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1497803597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 SAINT GEORGES AVE",
            "city": "AVENEL",
            "state": "NJ",
            "postal_code": "070011390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 LAWRENCE SQUARE BLVD S",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482674",
            "telephone_number": "609-587-6300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN DENTAL OF LAWRENCEVILLE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MISTRY",
        "authorized_official_first_name": "MANISH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "609-587-6300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "19184",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "10967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.