NPIMap

Organization Active NPI

North Jersey Laser Periodontics

  • Dental Clinic/Center
  • East Brunswick, NJ
National Provider Identifier
1790077097
Registry record updated May 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
22DI01947900 Issued in NJ
Legal business name
NORTH JERSEY LASER PERIODONTICS
Practice address
A3 Cornwall Dr
East Brunswick, NJ 08816-3352
Phone
(732) 257-7300
NPI assigned
May 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2011

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

Authorized official

Name
Daniel ReichNPI 1760556138
Title
Owner
Phone
(732) 257-7300

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
Dental Clinic/Center 261QD0000X 22DI01947900 NJ Primary

Addresses

Primary practice location

A3 Cornwall Dr
East Brunswick, NJ 08816-3352

Mailing address

139 Wilbur Rd
Bergenfield, NJ 07621-4036

Other names 1

  • Middlesex Periodontics & Dental Implants, PC Doing business as

National Provider Directory

National Provider Directory

Locations

A3 Cornwall Dr
East Brunswick, NJ 08816
Phone (732) 257-7300

Practitioners & affiliated clinicians

Practitioners 2

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": "1304553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304553600000",
    "number": "1790077097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 WILBUR RD",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076214036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "A3 CORNWALL DR",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163352",
            "telephone_number": "732-257-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH JERSEY LASER PERIODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-05",
        "last_updated": "2011-05-05",
        "status": "A",
        "authorized_official_last_name": "REICH",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-257-7300"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NJ",
            "license": "22DI01947900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Middlesex Periodontics & Dental Implants, PC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2011; 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.