Organization Active NPI

Elizabeth Center for Sleep and TMJ Wellness

  • Dentist
  • Elizabeth, NJ
National Provider Identifier
1720790207
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
ELIZABETH CENTER FOR SLEEP AND TMJ WELLNESS
Practice address
757 N Broad St
Elizabeth, NJ 07208-2482
Phone
(732) 221-6585
NPI assigned
Dec 15, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Authorized official

Name
Dr. Michelle Weddle, DDS
Title
Clinical Director/Member
Phone
(201) 600-0679

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X Primary

Addresses

Primary practice location

757 N Broad St
Elizabeth, NJ 07208-2482

Mailing address

10 Shawnee Dr Ste a-2
Watchung, NJ 07069-5803

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260226003311 NJ DME Supplier - Oral Surgery - Dentist 4789165713 Practice locations: Elizabeth, NJ

National Provider Directory

National Provider Directory

Locations

757 N Broad St
Elizabeth, NJ 07208
Phone (732) 221-6585

10 Shawnee Dr
Ste A2
Watchung, NJ 07069

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": "1671062400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671062400000",
    "number": "1720790207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 SHAWNEE DR STE A-2",
            "city": "WATCHUNG",
            "state": "NJ",
            "postal_code": "070695803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 N BROAD ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072082482",
            "telephone_number": "732-221-6585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH CENTER FOR SLEEP AND TMJ WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-15",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A",
        "authorized_official_last_name": "WEDDLE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR/MEMBER",
        "authorized_official_telephone_number": "201-600-0679",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.