Organization Active NPI

Diamond Braces of Norwalk

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Englewood, NJ
National Provider Identifier
1609253582
Registry record updated Apr 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
047218-1 Issued in NJ
Legal business name
DIAMOND BRACES OF NORWALK
Practice address
15 Engle St
Suite 303
Englewood, NJ 07631-2936
Phone
(201) 308-8181
NPI assigned
Apr 30, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2015

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

Authorized official

Name
Oleg Drut, DDS
Title
Owner
Phone
(201) 308-8181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 047218-1 NJ Primary

Addresses

Primary practice location

15 Engle St
Suite 303
Englewood, NJ 07631-2936

Mailing address

380 Sunrise Mall
Massapequa, NY 11758-4325
Phone (201) 308-8181

National Provider Directory

National Provider Directory
Tax ID family
Diamond Braces of Norwalk2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

15 Engle St
Ste 303
Englewood, NJ 07631
Phone (201) 308-8181

NPI Registry JSON

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

{
    "created_epoch": "1430352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430352000000",
    "number": "1609253582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 SUNRISE MALL",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117584325",
            "telephone_number": "201-308-8181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 ENGLE ST",
            "address_2": "SUITE 303",
            "city": "ENGLEWOOD",
            "state": "NJ",
            "postal_code": "076312936",
            "telephone_number": "201-308-8181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAMOND BRACES OF NORWALK",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-30",
        "last_updated": "2015-04-30",
        "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",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "047218-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Englewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2015; 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.