NPIMap

Organization Active NPI

Smart Dental Care PC

  • Dentist
  • Palisades Park, NJ
National Provider Identifier
1629401989
Registry record updated Aug 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02369100 Issued in NJ
Legal business name
SMART DENTAL CARE PC
Practice address
535 Broad Ave FL 2
Palisades Park, NJ 07650-1607
Phone
(917) 748-7355
NPI assigned
Aug 9, 2013
Last updated
Aug 9, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2013

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

Authorized official

Name
Matthew Min Kyu Kim, DDSNPI 1396943379
Title
President
Phone
(917) 748-7355

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 22DI02369100 NJ Primary

Addresses

Primary practice location

535 Broad Ave FL 2
Palisades Park, NJ 07650-1607

Mailing address

121 Towne St Apt 312
Stamford, CT 06902-5938

National Provider Directory

National Provider Directory

Locations

535 Broad Ave
#2
Palisades Park, NJ 07650
Phone (201) 592-0111

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376006400000",
    "number": "1629401989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 TOWNE ST APT 312",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069025938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 BROAD AVE FL 2",
            "city": "PALISADES PARK",
            "state": "NJ",
            "postal_code": "076501607",
            "telephone_number": "917-748-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMART DENTAL CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-09",
        "last_updated": "2013-08-09",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "MIN KYU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "917-748-7355",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02369100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palisades Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2013; 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.