Wyckoff Dental Associates, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14867 Issued in NJ

Legal business name

WYCKOFF DENTAL ASSOCIATES, LLC

Practice address

615 Wyckoff Ave
Wyckoff, NJ 07481-1343

Phone

(201) 891-0409

Fax

(201) 891-0803

NPI assigned

May 18, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Steven Arthur Menillo, DDS

Title

Owner/Partner

Phone

(201) 891-0409

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1211068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211068800000",
    "number": "1598922692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 WYCKOFF AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811343",
            "telephone_number": "201-891-0409",
            "fax_number": "201-891-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 WYCKOFF AVE",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811343",
            "telephone_number": "201-891-0409",
            "fax_number": "201-891-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYCKOFF DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-18",
        "last_updated": "2008-05-18",
        "status": "A",
        "authorized_official_last_name": "MENILLO",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "ARTHUR",
        "authorized_official_title_or_position": "OWNER/PARTNER",
        "authorized_official_telephone_number": "201-891-0409",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "14867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Catherine Weiss
• Jill Faber Werner, OTR/L
• Judy White
• Tom R Willemann, PT,OCS,MS
• Tiffani Michelle Winfrey
• Wyckoff Dental Spa LLC
• Wyckoff Family YMCA
• Wyckoff Ophthalmology, LLC
• Wyckoff Ophthalmology,LLC
• Wyckoff Optical, Inc.

• General Practice Dentistry in Wyckoff, NJ
• Providers in Wyckoff, 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 May 18, 2008; 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.