Alla Festina, DDS
Individual provider Active NPI General Practice Dentistry · Pine Beach, NJ
NPI 1922025675 · NPPES record last updated Mar 4, 2010
Key facts
- NPI
- 1922025675
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 22DI02070300 (NJ)
- Practice address
- 301 Prospect Ave
Pine Beach, NJ 08741-1044 - Phone
- (732) 341-1200
- Fax
- (732) 557-4542
- NPI assigned
- Jul 17, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02070300 | NJ | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22DI02070300 | NJ | Yes |
| Dentist | 122300000X | 22DI02070300 | NJ |
Addresses
Primary practice location
301 Prospect Ave
Pine Beach, NJ 08741-1044
Mailing address
301 Prospect Ave
Pine Beach, NJ 08741-1044
Phone (732) 341-1200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0221571 | Medicaid | NJ |
Other providers in Pine Beach, NJ
- Association for the Multiple Impaired Blind, Inc.
- Association for the Multiple Impaired Blind, Inc.
- Association for the Multiple Impaired Blind, Inc.
- Century Dental East
- Alan Cohn
- Horizons Unlimited LLC
- Lindsey Marie Janson
- Mariya Medlenov DDS LLC
- Mariya Medlenov
- MRL Vision Associates Inc
All providers in Pine Beach, NJ · General Practice Dentistry in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.