Cory a. Wanatick,D.M.D.,P.a.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DI018012 Issued in NJ

Legal business name

CORY A. WANATICK,D.M.D.,P.A.

Practice address

1563 Parker Ave
Fort Lee, NJ 07024-7002

Phone

(201) 461-4133

Fax

(201) 461-0796

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Cory A Wanatick, D.M.D.NPI 1194866517

Title

President

Phone

(201) 461-4133

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Cory Wanatick, DMD

  • Dentist
  • Highland Mills, NY
  • NPI 1194866517
  NPD (past) Authorized official
• Christine N Wong, DDS

  • Periodontics
  • New York, NY
  • NPI 1093073637
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508924754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1563 PARKER AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070247002",
            "telephone_number": "201-461-4133",
            "fax_number": "201-461-0796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1563 PARKER AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070247002",
            "telephone_number": "201-461-4133",
            "fax_number": "201-461-0796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORY A. WANATICK,D.M.D.,P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WANATICK",
        "authorized_official_first_name": "CORY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-461-4133",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "DI018012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Community Physical Therapists
• Dana C Compton, DMD
• Kristin A Concepcion, MD
• Jaquierra Cook, RN
• Kevin Corso, PT
• Counsel NJ LLC
• Counseling Services Incorporated
• Cranio Associates PA
• Cross Physical Therapy P C
• Jian Cui

• Periodontics in Fort Lee, NJ
• Providers in Fort Lee, NJ by specialty
• Periodontics 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.