Southjerseydentistry LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

22DI02287500 Issued in NJ

Legal business name

SOUTHJERSEYDENTISTRY LLC

Practice address

368 S White Horse Pike
Berlin, NJ 08009-1954

Phone

(856) 240-0406

NPI assigned

Sep 29, 2014

Organization subpart

No

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

Authorized official

Name

Mrs. Kosha Shah

Title

Manager

Phone

(856) 240-0406

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1411948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411948800000",
    "number": "1821491317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 S WHITE HORSE PIKE",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080091954",
            "telephone_number": "856-240-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "368 S WHITE HORSE PIKE",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080091954",
            "telephone_number": "856-240-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHJERSEYDENTISTRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-29",
        "last_updated": "2014-09-29",
        "status": "A",
        "authorized_official_last_name": "SHAH",
        "authorized_official_first_name": "KOSHA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "856-240-0406",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NJ",
            "license": "22DI02287500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca S Snyder, LAC
• Ajay Soni, DDS
• Shanna Soni, DDS
• South Jersey Behavioral Health Resources, Inc.
• South Jersey Recovery Program
• Patricia A Spiegel, DC
• Spring Oak Assisted Living at Voorhees LLC (Spring Oak Assisted living of Berlin)
• Heather Stang, PA
• Tanya Stankiewicz, NP
• Steininger Behavioral Care Services

• Dental Clinic/Center in Berlin, NJ
• Providers in Berlin, NJ by specialty
• Dental Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2014; 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.