Premium Dentistry

Primary specialty

DentistTaxonomy code 122300000X

License

22DI01842800 Issued in NJ

Legal business name

PREMIUM DENTISTRY

Practice address

6 W Spruce St
Lakewood, NJ 08701-5007

Phone

(732) 364-5100

Fax

(201) 927-3474

NPI assigned

May 9, 2018

Last updated

May 9, 2018By the provider in NPPES

Organization subpart

Yes

Parent organization

DENTAL ASSOCIATES OF LAKEWOODAs reported in NPPES

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

Authorized official

Name

Andre Shivrattan

Title

Credentialing Specialist

Phone

(347) 579-5159

Specialties & licenses 1

Addresses

Part of

Premium Dentistry

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Lakewood Dental Associates, LLC

  • Dentist
  • Lakewood, NJ
  • NPI 1760025894
  NPPES parent name

Practitioners 1

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.

• Alfonso Limone, DMD

  • General Practice Dentistry
  • Lakewood, NJ
  • NPI 1225182538
  NPD

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525824000000",
    "number": "1528557063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 W SPRUCE ST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015007",
            "telephone_number": "732-364-5100",
            "fax_number": "201-927-3474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 W SPRUCE ST",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015007",
            "telephone_number": "732-364-5100",
            "fax_number": "201-927-3474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIUM DENTISTRY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DENTAL ASSOCIATES OF LAKEWOOD",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-05-09",
        "status": "A",
        "authorized_official_last_name": "SHIVRATTAN",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "347-579-5159"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI01842800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premier Brain and Spine LLC
• Premier Choice Cardiology (Tanveer Ahmad)
• Premier Speech and Language LLC
• Premier Therapy LLC
• Premier Therapy PC
• Samuel A Preschel, MD
• Prescriptions R US (Prescriptions R Us LLC)
• Presidential Speech Therapy
• Prestige Home Care LLC
• Olgacy Price, M.A., L.P.C.

• Dentist in Lakewood, NJ
• Providers in Lakewood, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2018; 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.