Ridge Oral Surgery, Inc

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

Legal business name

RIDGE ORAL SURGERY, INC

Practice address

175 Morristown Rd Ste 103
Basking Ridge, NJ 07920-1657

Phone

(908) 395-0111

Fax

(908) 395-0108

NPI assigned

Mar 3, 2023

Organization subpart

No

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

Authorized official

Name

Prakhar Mehrotra, DDS, MDNPI 1740624121

Title

Owner/President

Phone

(908) 395-0111

Specialties & licenses 1

Addresses

Other names 1

• Mehrotra Enterprise Inc Former legal business name

Locations

Practitioners 2

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

• Prakhar Mehrotra, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Basking Ridge, NJ
  • NPI 1740624121
  NPD Authorized official
• Allison Derenzi, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Basking Ridge, NJ
  • NPI 1649895863
  NPD

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

{
    "created_epoch": "1677801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677801600000",
    "number": "1790485233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 MORRISTOWN RD STE 103",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079201657",
            "telephone_number": "908-395-0111",
            "fax_number": "908-395-0108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MORRISTOWN RD STE 103",
            "city": "BASKING RIDGE",
            "state": "NJ",
            "postal_code": "079201657",
            "telephone_number": "908-395-0111",
            "fax_number": "908-395-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGE ORAL SURGERY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-03",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A",
        "authorized_official_last_name": "MEHROTRA",
        "authorized_official_first_name": "PRAKHAR",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "908-395-0111",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mehrotra Enterprise Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Revive Neural Health
• Marc Francis Riccardi, DPT
• Frederick H. Richardson, DPT
• Susan Rider, D.D.S., M.S.D.
• Ridge Medical Supply LLC
• Ridge Womens Care PA
• Tracey A Rimmler, MSPT
• Leda Ristovic, RDN
• Nicolette Rittenhouse-Young, PSYD
• Riverwalk Healthcare Staffing, LLC

• Oral and Maxillofacial Surgery Clinic/Center in Basking Ridge, NJ
• Providers in Basking Ridge, NJ by specialty
• Oral and Maxillofacial Surgery Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; 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.