South Jersey Periodontics & Dental Implants, LLC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

Legal business name

SOUTH JERSEY PERIODONTICS & DENTAL IMPLANTS, LLC

Practice address

340 Egg Harbor Rd
Sewell, NJ 08080-1856

Phone

(856) 256-7778

Fax

(856) 256-7702

NPI assigned

Jul 5, 2024

Last updated

Jul 5, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Daniel Kubikian, DMDNPI 1619179702

Title

Owner

Phone

(856) 256-7778

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Daniel Kubikian, DMD

  • Periodontics
  • Sewell, NJ
  • NPI 1619179702
  NPD Authorized official

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

{
    "created_epoch": "1720137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720137600000",
    "number": "1730925173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 EGG HARBOR RD",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080801856",
            "telephone_number": "856-256-7778",
            "fax_number": "856-256-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 EGG HARBOR RD",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080801856",
            "telephone_number": "856-256-7778",
            "fax_number": "856-256-7702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH JERSEY PERIODONTICS & DENTAL IMPLANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-05",
        "last_updated": "2024-07-05",
        "certification_date": "2024-07-05",
        "status": "A",
        "authorized_official_last_name": "KUBIKIAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-256-7778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caren J. Sokolow, M.A.
• Ileana Somers, RPH
• Barbara Sorensen, M.D.
• South Jersey Heart Group
• South Jersey Musculoskeletal Institute, LLC (Advanced Surgical Institute)
• South Jersey Recovery Center LLC
• South Jersey Sports Medicine Center PC
• South Jersey Sports Medicine Center PC
• Lori Lynn Sowers, PHARMD
• Kelly Speers, PT, DPT

• Periodontics in Sewell, NJ
• Providers in Sewell, NJ by specialty
• Periodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2024; 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.