NPIMap

Organization Active NPI

Mary Flanagan LLC

Doing business as Pediatric Dentistry

  • Pediatric Dentistry
  • Clark, NJ
National Provider Identifier
1689077158
Registry record updated Sep 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
MARY FLANAGAN LLC
Doing business as
Pediatric Dentistry
Practice address
777 Raritan Rd
Clark, NJ 07066-2206
Phone
(732) 815-1977
Fax
(732) 815-1985
NPI assigned
Sep 29, 2014
Last updated
Sep 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2014

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

Authorized official

Name
Ms. Janet M Drennan
Title
Office Manager
Phone
(792) 815-1977

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

777 Raritan Rd
Clark, NJ 07066-2206

Mailing address

777 Raritan Rd
Clark, NJ 07066-2206
Phone (732) 818-1977

Other names 1

  • Pediatric Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

777 Raritan Rd
Clark, NJ 07066
Phone (732) 815-1977

Practitioners & affiliated clinicians

Practitioners 5

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": "1411948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411948800000",
    "number": "1689077158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 RARITAN RD",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070662206",
            "telephone_number": "732-818-1977",
            "fax_number": "732-815-1985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 RARITAN RD",
            "city": "CLARK",
            "state": "NJ",
            "postal_code": "070662206",
            "telephone_number": "732-815-1977",
            "fax_number": "732-815-1985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY FLANAGAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-29",
        "last_updated": "2014-09-29",
        "status": "A",
        "authorized_official_last_name": "DRENNAN",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "792-815-1977",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; 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.