Church Street Family and Cosmetic Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

17105 Issued in NJ

Legal business name

CHURCH STREET FAMILY AND COSMETIC DENTISTRY

Practice address

817 S Church St
Mount Laurel, NJ 08054-2503

Phone

(856) 778-2700

NPI assigned

Nov 24, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Venetia Zervos, DDSNPI 1467670877

Title

Dentist/Owner

Phone

(856) 778-2700

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Venetia J Zervos, DDS

  • General Practice Dentistry
  • Mount Laurel, NJ
  • NPI 1467670877
  NPD (past) Authorized official
• Shanni L. Reine-Mutch, DDS

  • Dentist
  • Mount Laurel, NJ
  • NPI 1639325491
  NPD (past)
• Hannah Yoon, D.M.D.

  • Dentist
  • Mount Laurel, NJ
  • NPI 1609204874
  NPD (past)

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

{
    "created_epoch": "1259020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259020800000",
    "number": "1801124110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 S CHURCH ST",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542503",
            "telephone_number": "856-778-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 S CHURCH ST",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542503",
            "telephone_number": "856-778-2700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHURCH STREET FAMILY AND COSMETIC DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-24",
        "last_updated": "2009-11-24",
        "status": "A",
        "authorized_official_last_name": "ZERVOS",
        "authorized_official_first_name": "VENETIA",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "856-778-2700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "17105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chiropractic Partners, LLC (Leonard F. Vernon, DC)
• Alexander Daniel Chisar
• Yoo Choi
• Alicia Chopyk, MA, MT-BC, NMT, CBIS
• Church Health Care, LLC (Innova Health and Rehab at Mt. Laurel)
• Vincent Ciccotelli, RPH
• Larisa Cipolone, MA, BCBA
• Andrea Nicole Clair
• James Fox Claire, D.O.
• Clarion Technology LLC (Trina Health of Mt. Laurel)

• General Practice Dentistry in Mount Laurel, NJ
• Providers in Mount Laurel, 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 Nov 24, 2009; 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.