NPIMap

Organization Active NPI

Rancocas Dental Associates, LLC

  • Dentist
  • Willingboro, NJ
National Provider Identifier
1710217500
Registry record updated Dec 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
RANCOCAS DENTAL ASSOCIATES, LLC
Practice address
620 Beverly Rancocas Rd
Willingboro, NJ 08046-3736
Phone
(609) 877-1818
Fax
(609) 877-0825
NPI assigned
Dec 30, 2009
Last updated
Dec 30, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2009

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

Authorized official

Name
Charles J Rose
Title
Managing Member
Phone
(856) 904-9946

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X Primary

Addresses

Primary practice location

620 Beverly Rancocas Rd
Willingboro, NJ 08046-3736

Mailing address

620 Beverly Rancocas Rd
Willingboro, NJ 08046-3736
Phone (609) 877-1818

National Provider Directory

National Provider Directory

Locations

620 Beverly Rancocas Rd
Willingboro, NJ 08046
Phone (609) 877-1818

Practitioners & affiliated clinicians

Practitioners 6

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": "1262131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262131200000",
    "number": "1710217500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 BEVERLY RANCOCAS RD",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080463736",
            "telephone_number": "609-877-1818",
            "fax_number": "609-877-0825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 BEVERLY RANCOCAS RD",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080463736",
            "telephone_number": "609-877-1818",
            "fax_number": "609-877-0825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANCOCAS DENTAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-30",
        "last_updated": "2009-12-30",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "856-904-9946"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willingboro, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2009; 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.