NPIMap

Organization Active NPI

Strong Roots Dental PC

  • General Practice Dentistry
  • Jersey Cith, NJ
National Provider Identifier
1598037996
Registry record updated Feb 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02410701 Issued in NJ
Legal business name
STRONG ROOTS DENTAL PC
Practice address
273 Newark Avenue
Jersey Cith, NJ 07302
Phone
(551) 200-6002
Fax
(201) 984-0607
NPI assigned
Jan 31, 2012
Last updated
Feb 28, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2019

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

Authorized official

Name
Mrs. Jahayra Juarez
Title
Office Manager
Phone
(551) 200-6002

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DIO2449200 NJ
General Practice Dentistry 1223G0001X 22DI02410701 NJ Primary

Addresses

Primary practice location

273 Newark Avenue
Jersey Cith, NJ 07302

Mailing address

273 Newark Avenue
Jersey Cith, NJ 07302
Phone (551) 200-6002

Other identifiers 1

IdentifierTypeStateIssuer
0257761MedicaidNJ

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1327968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551312000000",
    "number": "1598037996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "273 NEWARK AVENUE",
            "city": "JERSEY CITH",
            "state": "NJ",
            "postal_code": "07302",
            "telephone_number": "551-200-6002",
            "fax_number": "201-984-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "273 NEWARK AVENUE",
            "city": "JERSEY CITH",
            "state": "NJ",
            "postal_code": "07302",
            "telephone_number": "551-200-6002",
            "fax_number": "201-984-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STRONG ROOTS DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-31",
        "last_updated": "2019-02-28",
        "status": "A",
        "authorized_official_last_name": "JUAREZ",
        "authorized_official_first_name": "JAHAYRA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "551-200-6002",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DIO2449200",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02410701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0257761",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2019; 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.