NPIMap

Organization Active NPI

Jerald N. Rosenberg, DMD, LLC

  • Periodontics
  • Fair Lawn, NJ
National Provider Identifier
1811078785
Registry record updated Aug 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
22DI01598300 Issued in NJ
Legal business name
JERALD N. ROSENBERG, DMD, LLC
Practice address
19-21 Fair Lawn Ave
Suite 2H
Fair Lawn, NJ 07410-2331
Phone
(201) 794-0260
Fax
(201) 794-7697
NPI assigned
Oct 18, 2006
Last updated
Aug 23, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2016

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

Authorized official

Name
Dr. Jerald N. Rosenberg, D.M.D.NPI 1861573735
Title
Owner
Phone
(201) 794-0260

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
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 22DI01598300 NJ Primary

Addresses

Primary practice location

19-21 Fair Lawn Ave
Suite 2H
Fair Lawn, NJ 07410-2331

Mailing address

19-21 Fair Lawn Ave
Fair Lawn, NJ 07410-2331
Phone (201) 794-0260

National Provider Directory

National Provider Directory

Locations

19-21 Fair Lawn Ave
Ste 2H
Fair Lawn, NJ 07410
Phone (201) 794-0260

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471910400000",
    "number": "1811078785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19-21 FAIR LAWN AVE",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102331",
            "telephone_number": "201-794-0260",
            "fax_number": "201-794-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19-21 FAIR LAWN AVE",
            "address_2": "SUITE 2H",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102331",
            "telephone_number": "201-794-0260",
            "fax_number": "201-794-7697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERALD N. ROSENBERG, DMD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2016-08-23",
        "status": "A",
        "authorized_official_last_name": "ROSENBERG",
        "authorized_official_first_name": "JERALD",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-794-0260",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22DI01598300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; 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.