Vitruvian Dental Corporation

Primary specialty

DentistTaxonomy code 122300000X

License

21228 Issued in NJ

Legal business name

VITRUVIAN DENTAL CORPORATION

Practice address

577 Chestnut Ridge Rd
Woodcliff Lake, NJ 07677-8409

Phone

(201) 746-6003

NPI assigned

Jul 23, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Sang Moon, D.D.S.

Title

Dentist

Phone

(201) 527-7241

Specialties & licenses 1

Addresses

Other names 1

• Vitruvian Dental Doing business as

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

{
    "created_epoch": "1406073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1406073600000",
    "number": "1760890750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 CHESTNUT RIDGE RD",
            "city": "WOODCLIFF LAKE",
            "state": "NJ",
            "postal_code": "076778409",
            "telephone_number": "201-746-6003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 CHESTNUT RIDGE RD",
            "city": "WOODCLIFF LAKE",
            "state": "NJ",
            "postal_code": "076778409",
            "telephone_number": "201-746-6003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITRUVIAN DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-23",
        "last_updated": "2014-07-23",
        "status": "A",
        "authorized_official_last_name": "MOON",
        "authorized_official_first_name": "SANG",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "201-527-7241",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "21228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vitruvian Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Woodcliff Lake, NJ
• Providers in Woodcliff Lake, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2014; 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.