NPIMap

Organization Active NPI

Freehold Smiles Family Dentistry P.a.

  • General Practice Dentistry
  • Freehold, NJ
National Provider Identifier
1831532878
Registry record updated Apr 9, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02407801 Issued in NJ
Legal business name
FREEHOLD SMILES FAMILY DENTISTRY P.A.
Practice address
122 Professional View Dr
Building 100
Freehold, NJ 07728-7902
Phone
(732) 625-9600
Fax
(732) 625-9800
NPI assigned
Apr 9, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2013

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

Authorized official

Name
Dr. Maxim Sulla, DDS
Title
Owner
Phone
(732) 625-9600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 22DI02407801 NJ Primary

Addresses

Primary practice location

122 Professional View Dr
Building 100
Freehold, NJ 07728-7902

Mailing address

122 Professional View Dr
Building 100
Freehold, NJ 07728-7902
Phone (732) 625-9600

National Provider Directory

National Provider Directory

Locations

122 Professional View Dr
Bldg 100
Freehold, NJ 07728
Phone (732) 625-8080

NPI Registry JSON

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365465600000",
    "number": "1831532878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 PROFESSIONAL VIEW DR",
            "address_2": "BUILDING 100",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077287902",
            "telephone_number": "732-625-9600",
            "fax_number": "732-625-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 PROFESSIONAL VIEW DR",
            "address_2": "BUILDING 100",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077287902",
            "telephone_number": "732-625-9600",
            "fax_number": "732-625-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREEHOLD SMILES FAMILY DENTISTRY P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-09",
        "last_updated": "2013-04-09",
        "status": "A",
        "authorized_official_last_name": "SULLA",
        "authorized_official_first_name": "MAXIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-625-9600",
        "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": "22DI02407801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; 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.