Amara Dental of Wall, P.a.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI017432 Issued in NJ

Legal business name

AMARA DENTAL OF WALL, P.A.

Practice address

1933 Route 35
Unit 122
Wall Township, NJ 07719-3502

Phone

(732) 556-5000

Fax

(732) 556-5001

NPI assigned

Oct 10, 2016

Last updated

Feb 20, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephen Abbaticchio, DDS

Title

Owner

Phone

(908) 237-1216

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550620800000",
    "number": "1619427010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1144 HOOPER AVE",
            "address_2": "SUITE 301",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087538361",
            "telephone_number": "732-914-1039",
            "fax_number": "732-914-8472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1933 ROUTE 35",
            "address_2": "UNIT 122",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077193502",
            "telephone_number": "732-556-5000",
            "fax_number": "732-556-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMARA DENTAL OF WALL, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-10",
        "last_updated": "2019-02-20",
        "status": "A",
        "authorized_official_last_name": "ABBATICCHIO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-237-1216",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI017432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.