Bergen Healthcare LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI17749 Issued in NJ

Legal business name

BERGEN HEALTHCARE LLC

Practice address

539 Durie Ave
Closter, NJ 07624-2011

Phone

(201) 767-3666

Fax

(201) 767-6969

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Niki Shabnam Mossaded, DDSNPI 1154330876

Title

President

Phone

(201) 767-3666

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.

• Niki Shabnam Mossaded, DDS

  • Dentist
  • Closter, NJ
  • NPI 1154330876
  NPD (past) Authorized official
• Rudy Robert Rezzadeh, MD

  • Cardiovascular Disease Physician
  • Los Angeles, CA
  • NPI 1861558918
  NPD (past)

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558487587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 439",
            "city": "ALPINE",
            "state": "NJ",
            "postal_code": "076200439",
            "telephone_number": "201-767-3666",
            "fax_number": "201-767-6969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "539 DURIE AVE",
            "city": "CLOSTER",
            "state": "NJ",
            "postal_code": "076242011",
            "telephone_number": "201-767-3666",
            "fax_number": "201-767-6969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGEN HEALTHCARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOSSADED",
        "authorized_official_first_name": "NIKI",
        "authorized_official_middle_name": "SHABNAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-767-3666",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI17749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trella Blythe Allen, DPT
• Allergy and Asthma Center of Northern New Jersey LLC
• Sana Alomari
• Alan Douglas Andrews, M.D.
• Norman G Bartner, DMD
• Bergen Home Care LLC
• Bergen Orthodontic Assoc., PA
• Bergen Orthopaedic Surgery & Sports Medicine
• Michael Ryan Blanco, DPT
• Mona Teresa Lynch Boland, APN

• All providers in Closter, NJ
• General Practice Dentistry 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.