Shelton Oral Surgery & Implant Center, PC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

SHELTON ORAL SURGERY & IMPLANT CENTER, PC

Practice address

1146 Stuyvesant Ave
Irvington, NJ 07111-1059

Phone

(973) 849-6587

NPI assigned

Apr 29, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Andrew D Kim, DDSNPI 1578517801

Title

President

Phone

(973) 849-6587

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrew D Kim, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Newark, NJ
  • NPI 1578517801
  NPD Authorized official

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556496000000",
    "number": "1649834243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1146 STUYVESANT AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071111059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1146 STUYVESANT AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071111059",
            "telephone_number": "973-849-6587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELTON ORAL SURGERY & IMPLANT CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-29",
        "last_updated": "2019-04-29",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-849-6587",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Han Shao, MD
• Abhishek Sharma, D.D.S
• Stacy A Sharpe
• Shayanam LLC
• Shelleys Way
• Ein Yuan Alan Shen, MD
• Nakia Showers
• Lisa Silas, CPRS
• Morris Silver, DDS
• Ruth Silver, LCSW RN

• Oral and Maxillofacial Surgery (Dentist) in Irvington, NJ
• Providers in Irvington, NJ by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.