Innova Dental Solutions

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02567701 Issued in NJ

Legal business name

INNOVA DENTAL SOLUTIONS

Practice address

155 S New Prospect Rd
Jackson, NJ 08527-1734

Phone

(732) 364-1700

Fax

(732) 364-0870

NPI assigned

Mar 6, 2017

Organization subpart

No

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

Authorized official

Name

Mrs. Madhavi Kunduru

Title

Office Manager

Phone

(732) 364-1700

Specialties & licenses 1

Addresses

Practitioners 1

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

• Jeffrey T. Marvin, D.D.S.

  • General Practice Dentistry
  • Jackson, NJ
  • NPI 1962422501
  NPD (past)

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

{
    "created_epoch": "1488758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488758400000",
    "number": "1669912952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 S NEW PROSPECT RD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085271734",
            "telephone_number": "732-364-1700",
            "fax_number": "732-364-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 S NEW PROSPECT RD",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085271734",
            "telephone_number": "732-364-1700",
            "fax_number": "732-364-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVA DENTAL SOLUTIONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-06",
        "last_updated": "2017-03-06",
        "status": "A",
        "authorized_official_last_name": "KUNDURU",
        "authorized_official_first_name": "MADHAVI",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "732-364-1700",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02567701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• In Home Lymphatic Care
• In-House Dental Services
• Independent Rehab Services Limited Liability Company
• Inner Bloom Therapy
• Innova Dental Services LLC
• Interact Therapy Services, LLC
• Intrinsic Chiropractic Center
• Ivyrehab Network Inc
• Jackson Center for Foot and Ankle Medicine
• Jackson Center for Foot and Ankle Medicine,LLC

• General Practice Dentistry in Jackson, NJ
• Providers in Jackson, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2017; 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.