1137 Fort Lee LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

1137 FORT LEE LLC

Practice address

1625 Anderson Ave
Fort Lee, NJ 07024-2748

Phone

(201) 944-1260

NPI assigned

Apr 9, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Joseph Mauriello, D.D.S.

Title

Dentist

Phone

(201) 224-8180

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333929600000",
    "number": "1780940395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 ANDERSON AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070242748",
            "telephone_number": "201-944-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 ANDERSON AVE",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070242748",
            "telephone_number": "201-944-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1137 FORT LEE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-09",
        "last_updated": "2012-04-09",
        "status": "A",
        "authorized_official_last_name": "MAURIELLO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "201-224-8180",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Fort Lee, NJ
• Providers in Fort Lee, 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 Apr 9, 2012; 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.