NPIMap

Organization Active NPI

Eastern Dental Holdings, LLC

  • General Practice Dentistry
  • Avenel, NJ
National Provider Identifier
1770192239
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
EASTERN DENTAL HOLDINGS, LLC
Practice address
1030 St. Georges Avenue
Suite 304
Avenel, NJ 07001-1327
Phone
(732) 750-0707
Fax
(732) 750-5781
NPI assigned
Jul 30, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Authorized official

Name
Elan Schwarz, DMD
Title
Owner
Phone
(816) 953-5400

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
EndodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223E0200X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X
Oral and Maxillofacial Surgery (Dentist)Group: 193200000X MULTI-SPECIALTY GROUP 1223S0112X
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X

Addresses

Primary practice location

1030 St. Georges Avenue
Suite 304
Avenel, NJ 07001-1327

Mailing address

1030 St. Georges Avenue
Suite 304
Avenel, NJ 07001-1327
Phone (732) 750-0707

National Provider Directory

National Provider Directory

Locations

1030 Saint Georges Ave
Ste 304
Avenel, NJ 07001

Practitioners & affiliated clinicians

Practitioners 1

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": "1596067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1770192239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 ST. GEORGES AVENUE",
            "address_2": "SUITE 304",
            "city": "AVENEL",
            "state": "NJ",
            "postal_code": "070011327",
            "telephone_number": "732-750-0707",
            "fax_number": "732-750-5781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 ST. GEORGES AVENUE",
            "address_2": "SUITE 304",
            "city": "AVENEL",
            "state": "NJ",
            "postal_code": "070011327",
            "telephone_number": "732-750-0707",
            "fax_number": "732-750-5781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN DENTAL HOLDINGS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "SCHWARZ",
        "authorized_official_first_name": "ELAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "816-953-5400",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avenel, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.