Washington Pediatric Dentisry, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

22DI02420400 Issued in NJ

Legal business name

WASHINGTON PEDIATRIC DENTISRY, LLC

Practice address

197 S Washington Ave
Bergenfield, NJ 07621-2918

Phone

(201) 374-1686

NPI assigned

Sep 27, 2010

Last updated

Nov 16, 2010By 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. Wanyun Xue, D.D.S.

Title

Pediatric Dentist

Phone

(201) 374-1686

Specialties & licenses 1

Addresses

Locations

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.

• David Marc Blass, DMD

  • Dentist
  • Bergenfield, NJ
  • NPI 1871608430
  NPD (past)

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

{
    "created_epoch": "1285545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289865600000",
    "number": "1841509742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 S WASHINGTON AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076212918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 S WASHINGTON AVE",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076212918",
            "telephone_number": "201-374-1686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WASHINGTON PEDIATRIC DENTISRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-27",
        "last_updated": "2010-11-16",
        "status": "A",
        "authorized_official_last_name": "XUE",
        "authorized_official_first_name": "WANYUN",
        "authorized_official_title_or_position": "PEDIATRIC DENTIST",
        "authorized_official_telephone_number": "201-374-1686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02420400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Rite Aid #10416)
• Walgreen Co (Walgreens #07311)
• Walgreen Co (Rite Aid #19909)
• Amana Wang, D.C.
• Washington Dental Associates
• Way Rehab Services
• Way Rehab Services
• Josef M Weisgras, MD
• Dina Westrich, MD
• Kevin Whelan

• Pediatric Dentistry in Bergenfield, NJ
• Providers in Bergenfield, 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 Nov 16, 2010; 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.