Salazar Dental LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI024160 Issued in NJ

Legal business name

SALAZAR DENTAL LLC

Practice address

6219 Bergenline Ave
2ND FL
West New York, NJ 07093-1605

Phone

(201) 861-1007

NPI assigned

Aug 24, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Maria Jose Salazar, D.M.D

Title

Ceo

Phone

(201) 861-1007

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314144000000",
    "number": "1598045379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6219 BERGENLINE AVE",
            "address_2": "2ND FL",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070931605",
            "telephone_number": "201-861-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6219 BERGENLINE AVE",
            "address_2": "2ND FL",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070931605",
            "telephone_number": "201-861-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALAZAR DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-24",
        "last_updated": "2011-08-24",
        "status": "A",
        "authorized_official_last_name": "SALAZAR",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "JOSE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "201-861-1007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI024160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0243779",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mercedes Nancy Rudelli, MD
• Raul D Rudelli, MD
• Rustagi Eye Associates LLC
• Saras Rustagi, O.D.
• Saam Medical
• Maria Salazar, DMD
• Samantha P. Herman, M.D., LLC
• Bienvenido Sanchez, MD
• Christina Sanchez
• Daniel Rene Sanchez, M.D.

• General Practice Dentistry in West New York, NJ
• Providers in West New York, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.