NPIMap

Organization Active NPI

Perio Care Spa, PC

  • Periodontics
  • Cherry Hill, NJ
National Provider Identifier
1902962632
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
22D101115000 Issued in NJ
Legal business name
PERIO CARE SPA, PC
Practice address
1050 Kings Hwy N Ste 104
Cherry Hill, NJ 08034-1909
Phone
(856) 755-0992
NPI assigned
Dec 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Ira L Eisenstein, DMDNPI 1205914322
Title
Owner
Phone
(856) 755-0992

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X 22D101115000 NJ Primary

Addresses

Primary practice location

1050 Kings Hwy N Ste 104
Cherry Hill, NJ 08034-1909

Mailing address

1050 Kings Hwy N Ste 104
Cherry Hill, NJ 08034-1909
Phone (856) 755-0992

National Provider Directory

National Provider Directory

Locations

1050 Kings Hwy N
Ste 104
Cherry Hill, NJ 08034
Phone (856) 755-0992

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1902962632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 KINGS HWY N STE 104",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341909",
            "telephone_number": "856-755-0992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 KINGS HWY N STE 104",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080341909",
            "telephone_number": "856-755-0992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIO CARE SPA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "EISENSTEIN",
        "authorized_official_first_name": "IRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-755-0992",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22D101115000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • 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.