Pediatric Dental Associates of Clinton, P.a.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DI19623 Issued in NJ

Legal business name

PEDIATRIC DENTAL ASSOCIATES OF CLINTON, P.A.

Practice address

1465 State Route 31 S
Annandale, NJ 08801-3129

Phone

(908) 735-6300

Fax

(908) 735-6335

NPI assigned

Mar 29, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mary Johanna McGuire, DMDNPI 1184764862

Title

Owner

Phone

(908) 735-6300

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Mary Johanna McGuire, DMD

  • Pediatric Dentistry
  • Annandale, NJ
  • NPI 1184764862
  Authorized official Same address or phone

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841310554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 STATE ROUTE 31 S",
            "city": "ANNANDALE",
            "state": "NJ",
            "postal_code": "088013129",
            "telephone_number": "908-735-6300",
            "fax_number": "908-735-6335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 STATE ROUTE 31 S",
            "city": "ANNANDALE",
            "state": "NJ",
            "postal_code": "088013129",
            "telephone_number": "908-735-6300",
            "fax_number": "908-735-6335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL ASSOCIATES OF CLINTON, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCGUIRE",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "JOHANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-735-6300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "DI19623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Ozoria
• Dipakkumar Pravinchandra Pandya, M.D.
• Helen Jisoo Park, O.D.
• Bharatkumar R Patel, M.D
• Manisha Patel
• Portum Behavioral Health
• Portum Private Practice LLC
• Portum Private Practice LLC
• Portum Wellness and Recovery
• Preferred Therapeutics, LLC

• Pediatric Dentistry in Annandale, NJ
• Providers in Annandale, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.