NPIMap

Organization Active NPI

Advanced Dental LLC

  • Periodontics
  • Denville, NJ
National Provider Identifier
1619120664
Registry record updated Mar 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
18218 Issued in NJ
Legal business name
ADVANCED DENTAL LLC
Practice address
490 E Main St
Denville, NJ 07834-2484
Phone
(973) 586-4444
Fax
(973) 586-4455
NPI assigned
Nov 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2016

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

Authorized official

Name
Dr. Peter D Tsambazis, DMD
Title
Periodontist/Owner
Phone
(973) 586-4444

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 18218 NJ
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 18218 NJ Primary

Addresses

Primary practice location

490 E Main St
Denville, NJ 07834-2484

Mailing address

490 E Main St
Suite 103
Denville, NJ 07834-2484
Phone (973) 586-4444

National Provider Directory

National Provider Directory
Tax ID family
Advanced Dental LLC2 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.

NPI Registry JSON

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

{
    "created_epoch": "1225670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458518400000",
    "number": "1619120664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "490 E MAIN ST",
            "address_2": "SUITE 103",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "078342484",
            "telephone_number": "973-586-4444",
            "fax_number": "973-586-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "490 E MAIN ST",
            "city": "DENVILLE",
            "state": "NJ",
            "postal_code": "078342484",
            "telephone_number": "973-586-4444",
            "fax_number": "973-586-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED DENTAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-03",
        "last_updated": "2016-03-21",
        "status": "A",
        "authorized_official_last_name": "TSAMBAZIS",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PERIODONTIST/OWNER",
        "authorized_official_telephone_number": "973-586-4444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "18218",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "18218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2016; 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.