NPIMap

Organization Active NPI

Cedar Run Orthodontics, PA

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • West Creek, NJ
National Provider Identifier
1720236607
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
22DI02278100 Issued in NJ
Legal business name
CEDAR RUN ORTHODONTICS, PA
Practice address
1064 S Main St
Suite 2a
West Creek, NJ 08092-2912
Phone
(609) 978-4411
Fax
(609) 978-6677
NPI assigned
Sep 3, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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

Authorized official

Name
Dr. Gregory J Defelice
Title
President
Phone
(609) 978-4411

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 22DI02278100 NJ Primary

Addresses

Primary practice location

1064 S Main St
Suite 2a
West Creek, NJ 08092-2912

Mailing address

1064 S Main St
Suite 2a
West Creek, NJ 08092-2912
Phone (609) 978-4411

National Provider Directory

National Provider Directory

Locations

1064 S Main St
Bldg 2A
West Creek, NJ 08092
Phone (609) 978-4411

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220400000000",
    "number": "1720236607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1064 S MAIN ST",
            "address_2": "SUITE 2A",
            "city": "WEST CREEK",
            "state": "NJ",
            "postal_code": "080922912",
            "telephone_number": "609-978-4411",
            "fax_number": "609-978-6677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1064 S MAIN ST",
            "address_2": "SUITE 2A",
            "city": "WEST CREEK",
            "state": "NJ",
            "postal_code": "080922912",
            "telephone_number": "609-978-4411",
            "fax_number": "609-978-6677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR RUN ORTHODONTICS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A",
        "authorized_official_last_name": "DEFELICE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-978-4411",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "22DI02278100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Creek, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; 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.