NPIMap

Organization Active NPI

Pequannock Valley Dental Associates

  • General Practice Dentistry
  • Pompton Plains, NJ
National Provider Identifier
1770779902
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02208900 Issued in NJ
Legal business name
PEQUANNOCK VALLEY DENTAL ASSOCIATES
Practice address
567 Newark Pompton Tpke
Pompton Plains, NJ 07444-1737
Phone
(973) 831-0444
Fax
(973) 831-7770
NPI assigned
Sep 20, 2007
Last updated
Sep 20, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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

Authorized official

Name
Dr. Brian M Marino, D.M.DNPI 1366507022
Title
Owner
Phone
(973) 831-0444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 22DI02208900 NJ Primary

Addresses

Primary practice location

567 Newark Pompton Tpke
Pompton Plains, NJ 07444-1737

Mailing address

567 Newark Pompton Tpke
Pompton Plains, NJ 07444-1737
Phone (973) 831-0444

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190246400000",
    "number": "1770779902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "567 NEWARK POMPTON TPKE",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "074441737",
            "telephone_number": "973-831-0444",
            "fax_number": "973-831-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 NEWARK POMPTON TPKE",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "074441737",
            "telephone_number": "973-831-0444",
            "fax_number": "973-831-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEQUANNOCK VALLEY DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A",
        "authorized_official_last_name": "MARINO",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-831-0444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02208900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pompton Plains, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; 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.