South Bergen Oral Surgery PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

9227 Issued in NJ

Legal business name

SOUTH BERGEN ORAL SURGERY PA

Practice address

422 Stuyvesant Ave
Lyndhurst, NJ 07071

Phone

(201) 935-4577

Fax

(201) 935-8893

NPI assigned

Dec 4, 2006

Last updated

Aug 22, 2020By 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. James P Dilascio, DDS

Title

President So Bergen Oral Surgery PA

Phone

(201) 935-4577

Specialties & licenses 2

Addresses

Other identifiers 1

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.

• Gerald Paul Devlin

  • Oral and Maxillofacial Surgery (Dentist)
  • Lyndhurst, NJ
  • NPI 1457424137
  NPD (past)

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1699833566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 STUYVESANT AVE",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "07071",
            "telephone_number": "201-935-4577",
            "fax_number": "201-935-8893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 STUYVESANT AVE",
            "city": "LYNDHURST",
            "state": "NJ",
            "postal_code": "07071",
            "telephone_number": "201-935-4577",
            "fax_number": "201-935-8893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH BERGEN ORAL SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DILASCIO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT SO BERGEN ORAL SURGERY PA",
        "authorized_official_telephone_number": "201-935-4577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "9227",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "9218",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PIN",
            "identifier": "058001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• SKR Medical Advisors
• Zulieta Smoljan, LMSW
• Rosa Maria Solano-Trelles
• Jin Myung Soun, PHARM D
• South Bergen Oral Maxillofacial Surgery LLC
• Vincent G Spinazzola, D.C.
• St John of Lotus Healthcare Services Inc
• Steve Fallek MD
• Diane J Strickland
• Marina A Strizhevsky, DO

• Oral and Maxillofacial Surgery (Dentist) in Lyndhurst, NJ
• Providers in Lyndhurst, 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 Aug 22, 2020; 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.