Cobblestone Kids Pediatric Dentistry of New Jersey

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

COBBLESTONE KIDS PEDIATRIC DENTISTRY OF NEW JERSEY

Practice address

17 W Ormond Ave
Cherry Hill, NJ 08002-3041

Phone

(856) 288-1929

NPI assigned

Apr 22, 2021

Organization subpart

No

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

Authorized official

Name

Kate Melidosian, MHA, MHRM

Title

Director of Operations

Phone

(267) 909-9551

Specialties & licenses 1

Addresses

Practitioners 1

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

• George Thomas Lynch IV, DMD

  • Pediatric Dentistry
  • Philadelphia, PA
  • NPI 1548464761
  NPD (past)

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

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1790367431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1352 SOUTH ST STE C4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191471858",
            "telephone_number": "267-909-9551",
            "fax_number": "267-909-9761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 W ORMOND AVE",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080023041",
            "telephone_number": "856-288-1929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBBLESTONE KIDS PEDIATRIC DENTISTRY OF NEW JERSEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-22",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "MELIDOSIAN",
        "authorized_official_first_name": "KATE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "267-909-9551",
        "authorized_official_credential": "MHA, MHRM"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• CMC Department of Medicine
• CMC Department of Medicine
• CMC Department of Medicine Group PA
• Madeline Cobb, DROT
• Sarah Elizabeth Cobb, OT
• Kelsey Cocron
• Jennifer Anne Cocuzza, OTR
• L. Michelle Codington, MS, LMFT
• William C. Cody, M.D.
• Diana M. Cofsky, L.P.C.

• Pediatric Dentistry in Cherry Hill, NJ
• Providers in Cherry Hill, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.