NPIMap

Organization Active NPI

Brilliant Smiles Dental Group - Magnolia LLC

  • Dentist
  • Magnolia, NJ
National Provider Identifier
1538455324
Registry record updated Jun 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DI02244000 Issued in NJ
Legal business name
BRILLIANT SMILES DENTAL GROUP - MAGNOLIA LLC
Doing business as
Hometown Family Dental
Practice address
402 White Horse Pike S
Magnolia, NJ 08049-1061
Phone
(856) 566-9700
NPI assigned
Jun 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2011

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

Authorized official

Name
Dr. Michelle Aitken, DDS
Title
Owner
Phone
(856) 566-9700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X DI02244000 NJ Primary

Addresses

Primary practice location

402 White Horse Pike S
Magnolia, NJ 08049-1061

Mailing address

402 White Horse Pike S
Magnolia, NJ 08049-1061

Other names 1

  • Hometown Family Dental Doing business as

National Provider Directory

National Provider Directory

Locations

402 S White Horse Pike
Magnolia, NJ 08049
Phone (856) 566-9700

Practitioners & affiliated clinicians

Practitioners 4

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": "1308614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308614400000",
    "number": "1538455324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 WHITE HORSE PIKE S",
            "city": "MAGNOLIA",
            "state": "NJ",
            "postal_code": "080491061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 WHITE HORSE PIKE S",
            "city": "MAGNOLIA",
            "state": "NJ",
            "postal_code": "080491061",
            "telephone_number": "856-566-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRILLIANT SMILES DENTAL GROUP - MAGNOLIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-21",
        "last_updated": "2011-06-21",
        "status": "A",
        "authorized_official_last_name": "AITKEN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-566-9700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI02244000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hometown Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Magnolia, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; 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.