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

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, DMD

Title

Owner

Phone

(908) 735-6300

Specialties & licenses 1

Addresses

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": []
}

• Dipakkumar Pravinchandra Pandya, M.D.
• Helen Jisoo Park, O.D.
• Bharatkumar R Patel, M.D
• Manisha Patel
• Milan Patel, D.M.D.
• 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.