Organization Active NPI

Raritan Bay Oral Surgery

  • Dental Clinic/Center
  • Woodbridge, NJ
National Provider Identifier
1528702891
Registry record updated Apr 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
RARITAN BAY ORAL SURGERY
Doing business as
Raritan Bay Oral Surgery
Practice address
453 Amboy Ave Ste 2
Woodbridge, NJ 07095-2949
Phone
(732) 442-1860
Fax
(732) 874-5198
NPI assigned
Apr 23, 2022
Last updated
Apr 23, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
45-3358409As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 23, 2022

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

Authorized official

Name
George Flugrad Sr., DMDNPI 1598745531
Title
Oral Surgeron/Owner
Phone
(732) 442-1860

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 1

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

Addresses

Primary practice location

453 Amboy Ave Ste 2
Woodbridge, NJ 07095-2949

Mailing address

453 Amboy Ave Ste 2
Woodbridge, NJ 07095-2949
Phone (732) 442-1860

Other identifiers 3

IdentifierTypeStateIssuer
1598745531MedicaidNJ
0285391MedicaidNJ
1873407MedicaidNJ

Other names 1

  • Raritan Bay Oral Surgery Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL info@fixmyface.org Direct

National Provider Directory

National Provider Directory
Part of
Solimine Flugrad DMD

Locations

453 Amboy Ave
Ste 2
Woodbridge, NJ 07095
Phone (732) 442-1860

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1650672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650672000000",
    "number": "1528702891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "453 AMBOY AVE STE 2",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070952949",
            "telephone_number": "732-442-1860",
            "fax_number": "732-874-5198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "453 AMBOY AVE STE 2",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070952949",
            "telephone_number": "732-442-1860",
            "fax_number": "732-874-5198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RARITAN BAY ORAL SURGERY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "45-3358409",
        "enumeration_date": "2022-04-23",
        "last_updated": "2022-04-23",
        "certification_date": "2022-04-23",
        "status": "A",
        "authorized_official_last_name": "FLUGRAD",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "ORAL SURGERON/OWNER",
        "authorized_official_telephone_number": "732-442-1860",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598745531",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0285391",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1873407",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "info@fixmyface.org",
            "affiliation": "N",
            "endpointDescription": "Endpoint",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "453 Amboy Ave Ste 2",
            "city": "Woodbridge",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070952949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Raritan Bay Oral Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodbridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2022; 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.