Kenilworth Dental Associates, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

14638 Issued in NJ

Legal business name

KENILWORTH DENTAL ASSOCIATES, LLC

Practice address

513 Boulevard
Kenilworth, NJ 07033-1637

Phone

(908) 276-6652

Fax

(908) 709-4337

NPI assigned

Nov 1, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Jerome Scott Forman, D.M.D.NPI 1679650931

Title

Owner

Phone

(908) 276-6652

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Jerome Scott Forman, D.M.D.

  • General Practice Dentistry
  • Kenilworth, NJ
  • NPI 1679650931
  NPD (past) Authorized official
• Sakshi Sapru

  • General Practice Dentistry
  • Bridgewater, NJ
  • NPI 1629704911
  NPD (past)
• David Allen Steele, DMD

  • General Practice Dentistry
  • Kenilworth, NJ
  • NPI 1679610166
  NPD (past)

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710064977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 BOULEVARD",
            "city": "KENILWORTH",
            "state": "NJ",
            "postal_code": "070331637",
            "telephone_number": "908-276-6652",
            "fax_number": "908-709-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 BOULEVARD",
            "city": "KENILWORTH",
            "state": "NJ",
            "postal_code": "070331637",
            "telephone_number": "908-276-6652",
            "fax_number": "908-709-4337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENILWORTH DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FORMAN",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-276-6652",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "14638",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bhavani Jeereddy, MD
• Erica Kane
• Sean L. Kaufman, D.P.M
• Ahmad Kazemi, MD
• Courtney Keating, LAT, ATC
• Kenilworth Primary Care LLC
• Kenilworth School District
• Tony Pierre Kerbaj, DPM
• Kero Transportation Inc.,
• Karen Kiefer, APN

• General Practice Dentistry in Kenilworth, NJ
• Providers in Kenilworth, 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 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.