Organization Active NPI

Desalvo & Shyong PC

Doing business as DeSalvo Dental

  • Dentist
  • Fort Lee, NJ
National Provider Identifier
1619045333
Registry record updated Jan 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DI017994 Issued in NJ
Legal business name
DESALVO & SHYONG PC
Doing business as
DeSalvo Dental
Practice address
264 Columbia Ave
Fort Lee, NJ 07024
Phone
(201) 224-3232
Fax
(201) 224-6030
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2010

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

Authorized official

Name
Dr. Patricia Gina Desalvo, DMD
Title
Dentist Owner
Phone
(201) 224-3232

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DI017994 NJ Primary

Addresses

Primary practice location

264 Columbia Ave
Fort Lee, NJ 07024

Mailing address

264 Columbia Ave
Fort Lee, NJ 07024
Phone (201) 224-3232

Other names 1

  • DeSalvo Dental Doing business as

National Provider Directory

National Provider Directory

Locations

264 Columbia Ave
Fort Lee, NJ 07024
Phone (201) 224-3232

NPI Registry JSON

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263168000000",
    "number": "1619045333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 COLUMBIA AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "07024",
            "telephone_number": "201-224-3232",
            "fax_number": "201-224-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 COLUMBIA AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "07024",
            "telephone_number": "201-224-3232",
            "fax_number": "201-224-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESALVO & SHYONG PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2010-01-11",
        "status": "A",
        "authorized_official_last_name": "DESALVO",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "GINA",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "201-224-3232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI017994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DeSalvo Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Lee, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; 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.