Elizabeth Smiline Dental, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

22DI01912604 Issued in NJ

Legal business name

ELIZABETH SMILINE DENTAL, LLC

Practice address

1206 E Grand St
Elizabeth, NJ 07201-2309

Phone

(908) 351-4860

Fax

(908) 351-4865

NPI assigned

Mar 23, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Usha Polavarapu, D.D.S.

Title

Dentist

Phone

(908) 351-4860

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1300838400000",
    "number": "1831498328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1206 E GRAND ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072012309",
            "telephone_number": "908-351-4860",
            "fax_number": "908-351-4865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 E GRAND ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072012309",
            "telephone_number": "908-351-4860",
            "fax_number": "908-351-4865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELIZABETH SMILINE DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-23",
        "last_updated": "2011-03-23",
        "status": "A",
        "authorized_official_last_name": "POLAVARAPU",
        "authorized_official_first_name": "USHA",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "908-351-4860",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI01912604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Pharmacy Inc
• Elizabeth Physical Therapy & Elizabeth Foot and Ankle Association
• Elizabeth Primary Care, LLC
• Elizabeth Public Schools
• Elizabeth Radiology Associates, P.a.
• Elizabeth Sono Medical
• Elizabeth Sono Medical, PLLC
• Neveen A. Elkholy, D.O.
• Souhaib Elkoun
• Robert Elliott, RPH

• Dentist in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; 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.