Independence Dental Associates, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

22DI01371800 Issued in NJ

Legal business name

INDEPENDENCE DENTAL ASSOCIATES, LLC

Practice address

915 Route 517
Hackettstown, NJ 07840-4661

Phone

(908) 852-2215

Fax

(908) 852-0831

NPI assigned

Jul 29, 2011

Last updated

Aug 18, 2011By 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

Dr. Richard J Cleave, DMDNPI 1073602108

Title

Owner

Phone

(908) 852-2215

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, and the practitioner matching its NPPES authorized official.

• Richard James Cleave III, D.M.D.

  • General Practice Dentistry
  • Hackettstown, NJ
  • NPI 1073602108
  Authorized official Same address or phone

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

{
    "created_epoch": "1311897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313625600000",
    "number": "1699053355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 ROUTE 517",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078404661",
            "telephone_number": "908-852-2215",
            "fax_number": "908-852-0831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 ROUTE 517",
            "city": "HACKETTSTOWN",
            "state": "NJ",
            "postal_code": "078404661",
            "telephone_number": "908-852-2215",
            "fax_number": "908-852-0831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-29",
        "last_updated": "2011-08-18",
        "status": "A",
        "authorized_official_last_name": "CLEAVE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-852-2215",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NJ",
            "license": "22DI01371800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Independence Dental Associates, LLC
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• Keri Lynn Ingrassia-Squiers, DO
• Inhouse MD LLC

• Dental Clinic/Center in Hackettstown, NJ
• Providers in Hackettstown, NJ by specialty
• Dental Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; 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.