Diamond Braces of Hackensack

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

02070700 Issued in NJ

Legal business name

DIAMOND BRACES OF HACKENSACK

Practice address

17 Summit Ave
Hackensack, NJ 07601-1218

Phone

(201) 996-0770

Fax

(201) 875-5588

NPI assigned

Mar 6, 2017

Organization subpart

No

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

Authorized official

Name

Oleg Drut

Title

Owner

Phone

(201) 308-8181

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488758400000",
    "number": "1568902807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 ENGLE ST",
            "address_2": "SUITE 303",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312936",
            "telephone_number": "201-996-0770",
            "fax_number": "201-875-5588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 SUMMIT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011218",
            "telephone_number": "201-996-0770",
            "fax_number": "201-875-5588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAMOND BRACES OF HACKENSACK",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-06",
        "last_updated": "2017-03-06",
        "status": "A",
        "authorized_official_last_name": "DRUT",
        "authorized_official_first_name": "OLEG",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-308-8181"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "02070700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shilpa Santosh Dewoolkar, OTRL CHT
• Seema P. Dhorajia, D.O
• James Carlo Di Palma-Grisi, MD
• Emil Di Perna, RP
• Diagnostic Pathology Laboratories, PA
• Jason Diamond, DDS MD
• Steven Howard Diamond, M.D.
• Dianne Thomas MD LLC
• Brenda Diaz, RN, APN
• Christopher Samuel Diaz

• Orthodontics and Dentofacial Orthopedics Dentistry in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2017; 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.