NPIMap

Organization Active NPI

The Smile Spa of North Jersey,LLC

  • General Practice Dentistry
  • Midland Park, NJ
National Provider Identifier
1710151089
Registry record updated May 10, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14180 Issued in NJ
Legal business name
THE SMILE SPA OF NORTH JERSEY,LLC
Practice address
251 Godwin Ave
Midland Park, NJ 07432-1882
Phone
(201) 445-2797
Fax
(201) 445-8340
NPI assigned
Apr 17, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2010

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

Authorized official

Name
Dr. Debra Rosenblatt, DDSNPI 1588642664
Title
Proprieter
Phone
(201) 445-2797

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 14180 NJ Primary
PeriodonticsGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0300X 2920508 NJ

Addresses

Primary practice location

251 Godwin Ave
Midland Park, NJ 07432-1882

Mailing address

251 Godwin Ave
Midland Park, NJ 07432-1882
Phone (201) 445-2797

Other identifiers 1

IdentifierTypeStateIssuer
1301802MedicaidNJ

National Provider Directory

National Provider Directory
Tax ID family
The Smile Spa of North Jerseyllc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273449600000",
    "number": "1710151089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 GODWIN AVE",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321882",
            "telephone_number": "201-445-2797",
            "fax_number": "201-445-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "251 GODWIN AVE",
            "city": "MIDLAND PARK",
            "state": "NJ",
            "postal_code": "074321882",
            "telephone_number": "201-445-2797",
            "fax_number": "201-445-8340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE SMILE SPA OF NORTH JERSEY,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-17",
        "last_updated": "2010-05-10",
        "status": "A",
        "authorized_official_last_name": "ROSENBLATT",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "PROPRIETER",
        "authorized_official_telephone_number": "201-445-2797",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "14180",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "2920508",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1301802",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; 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.