Cranbrook Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI01914200 Issued in NJ

Legal business name

CRANBROOK DENTAL, LLC

Practice address

2312 Whitehorse Mercerville Rd
Suite 200a
Mercerville, NJ 08619-1953

Phone

(609) 587-0049

NPI assigned

Apr 4, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Richard J. Federico, DMDNPI 1902928682

Title

Owner

Phone

(609) 587-0049

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Richard J. Federico, DMD

  • General Practice Dentistry
  • Mercerville, NJ
  • NPI 1902928682
  NPD (past) Authorized official
• Eugene Gutman, D.M.D.

  • General Practice Dentistry
  • Mercerville, NJ
  • NPI 1285857979
  NPD (past)

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790807428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2312 WHITEHORSE MERCERVILLE RD",
            "address_2": "SUITE 200A",
            "city": "MERCERVILLE",
            "state": "NJ",
            "postal_code": "086191953",
            "telephone_number": "609-587-0049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2312 WHITEHORSE MERCERVILLE RD",
            "address_2": "SUITE 200A",
            "city": "MERCERVILLE",
            "state": "NJ",
            "postal_code": "086191953",
            "telephone_number": "609-587-0049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRANBROOK DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FEDERICO",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-587-0049",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI01914200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gary Anthony Cortina, D.M.D.
• Coughlin Consultation Group, P.a.
• Ronald Coughlin, ED.D
• Sean R. Crocker, PA-C
• Andrew Davidson
• DBP Optical
• Laurie Lee Deangelo, MA EDS
• Lianne Margaret Dehnam, ANP BC

• General Practice Dentistry in Mercerville, NJ
• Providers in Mercerville, 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 Aug 22, 2020; 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.