NPIMap

Organization Active NPI

Dental Mentors

  • Dental Clinic/Center
  • Lincoln Park, NJ
National Provider Identifier
1710300702
Registry record updated Oct 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DI18340 Issued in NJ
Legal business name
DENTAL MENTORS
Practice address
166 Main St
Suite 1B
Lincoln Park, NJ 07035-3707
Phone
(973) 628-1449
Fax
(973) 696-0037
NPI assigned
Jan 27, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2015

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

Authorized official

Name
Dr. John A Taltavall III, DMDNPI 1851516926
Title
Partner
Phone
(973) 628-1449

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
Dental Clinic/Center 261QD0000X DI18340 NJ Primary
Dental Clinic/Center 261QD0000X DI18175 NJ

Addresses

Primary practice location

166 Main St
Suite 1B
Lincoln Park, NJ 07035-3707

Mailing address

PO Box 457
166 Main Street Suite 1B
Lincoln Park, NJ 07035-0457
Phone (973) 628-1449

Other names 1

  • Dental Sleep Alternatives Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1390780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444003200000",
    "number": "1710300702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 457",
            "address_2": "166 MAIN STREET SUITE 1B",
            "city": "LINCOLN PARK",
            "state": "NJ",
            "postal_code": "070350457",
            "telephone_number": "973-628-1449",
            "fax_number": "973-696-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "166 MAIN ST",
            "address_2": "SUITE 1B",
            "city": "LINCOLN PARK",
            "state": "NJ",
            "postal_code": "070353707",
            "telephone_number": "973-628-1449",
            "fax_number": "973-696-0037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL MENTORS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-27",
        "last_updated": "2015-10-05",
        "status": "A",
        "authorized_official_last_name": "TALTAVALL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "973-628-1449",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NJ",
            "license": "DI18340",
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NJ",
            "license": "DI18175",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Sleep Alternatives",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; 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.