Peb Dental DDS PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

0101028295 Issued in NJ

Legal business name

PEB DENTAL DDS PA

Practice address

230 Route 18
East Brunswick, NJ 08816-1909

Phone

(732) 609-9106

Fax

(732) 752-1268

NPI assigned

Jan 8, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Vijaya Radakrishna, M.D.

Title

Pediatrician

Phone

(732) 752-1932

Specialties & licenses 1

Addresses

Tax ID family

Peb Dental DDS PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Peb Dental DDS/PA

  • General Practice Dentistry
  • Piscataway, NJ
  • NPI 1437547890
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anna Gill Uppal, DDS

  • Dentist
  • Folsom, CA
  • NPI 1467861773
  NPD (past)

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

{
    "created_epoch": "1420675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420675200000",
    "number": "1770971103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 ROUTE 18",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088161909",
            "telephone_number": "732-609-9106",
            "fax_number": "732-752-1268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 ROUTE 18",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088161909",
            "telephone_number": "732-609-9106",
            "fax_number": "732-752-1268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEB DENTAL DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-08",
        "last_updated": "2015-01-08",
        "status": "A",
        "authorized_official_last_name": "RADAKRISHNA",
        "authorized_official_first_name": "VIJAYA",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "732-752-1932",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "0101028295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia N Iannotta MD LLC
• Deepak Patwardhan
• Dennise Paule, DPT
• Kenneth L Pearce
• Pearle Vision Inc
• Pediatric Dental Care, PC
• Pediatric Orthopedic Associates, P.a.
• Pediatric Urology Associates, P.C.
• Ariana Mercedez Pena, LSW
• David Pepose, PA

• General Practice Dentistry in East Brunswick, NJ
• Providers in East Brunswick, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2015; 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.