Active NPI
State Street-Orthodontics LLC
- Orthodontics and Dentofacial Orthopedics Dentistry
- Hackensack, NJ
National Provider Identifier
1912852682
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- Legal business name
- STATE STREET-ORTHODONTICS LLC
- Practice address
- 405 Main St
Hackensack, NJ 07601-5965 - Phone
- (201) 487-7030
- Fax
- (201) 487-4418
- NPI assigned
- Feb 27, 2026
- Last updated
- Feb 27, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Edward Michael Jackson, DMD
- Title
- Owner
- Phone
- (201) 487-7030
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | NU | Primary |
Addresses
Primary practice location
405 Main St
Hackensack, NJ 07601-5965
Mailing address
405 Main St
Hackensack, NJ 07601-5965
Phone (201) 487-7030
National Provider Directory
National Provider DirectoryLocations
405 Main St
Hackensack, NJ 07601
Phone (201) 487-7030
Practitioners & affiliated clinicians
Practitioners 3
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.
-
- Pediatric Dentistry
- Hackensack, NJ
- NPI 1477640373
-
- Dentist
- Hackensack, NJ
- NPI 1295816411
-
- Pediatric Dentistry
- Brooklyn, NY
- NPI 1700273224
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1772150400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1772150400000",
"number": "1912852682",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 MAIN ST",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076015965",
"telephone_number": "201-487-7030",
"fax_number": "201-487-4418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 MAIN ST",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "076015965",
"telephone_number": "201-487-7030",
"fax_number": "201-487-4418"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "STATE STREET-ORTHODONTICS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-02-27",
"last_updated": "2026-02-27",
"certification_date": "2026-02-27",
"status": "A",
"authorized_official_last_name": "JACKSON",
"authorized_official_first_name": "EDWARD",
"authorized_official_middle_name": "MICHAEL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "201-487-7030",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DMD"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hackensack, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.