Organization Active NPI

Garden State Smiles of North Brunswick

  • General Practice Dentistry
  • North Brunswick, NJ
National Provider Identifier
1558720698
Registry record updated Feb 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DI021211 Issued in NJ
Legal business name
GARDEN STATE SMILES OF NORTH BRUNSWICK
Practice address
1612 Route 27
North Brunswick, NJ 08902-1451
Phone
(732) 846-6767
NPI assigned
Feb 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2016

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

Authorized official

Name
Dr. Vlad Detinich, DMD
Title
President
Phone
(732) 322-9297

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X DI021211 NJ Primary

Addresses

Primary practice location

1612 Route 27
North Brunswick, NJ 08902-1451

Mailing address

1612 Route 27
North Brunswick, NJ 08902-1451
Phone (732) 846-6767

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1455667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455667200000",
    "number": "1558720698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 ROUTE 27",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089021451",
            "telephone_number": "732-846-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1612 ROUTE 27",
            "city": "NORTH BRUNSWICK",
            "state": "NJ",
            "postal_code": "089021451",
            "telephone_number": "732-846-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN STATE SMILES OF NORTH BRUNSWICK",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-17",
        "last_updated": "2016-02-17",
        "status": "A",
        "authorized_official_last_name": "DETINICH",
        "authorized_official_first_name": "VLAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-322-9297",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI021211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2016; 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.