Dental PM PC

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02512900 Issued in NJ

Legal business name

DENTAL PM PC

Practice address

175 Market St
3Rd Floor
Paterson, NJ 07505-1728

Phone

(201) 737-7283

NPI assigned

Oct 9, 2015

Last updated

Jul 20, 2023By 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. Rafael D Rodriguez, DDSNPI 1336351964

Title

Ceo

Phone

(201) 737-7283

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

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.

• Rafael D Rodriguez, DDS

  • Dentist
  • Paterson, NJ
  • NPI 1336351964
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1444348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1932570462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4532 KENNEDY BLVD",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070872707",
            "telephone_number": "201-737-7283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 MARKET ST",
            "address_2": "3RD FLOOR",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075051728",
            "telephone_number": "201-737-7283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTAL PM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-09",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "RAFAEL",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "201-737-7283",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02512900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yuliya Dementyeva, MD
• Fatima S Demirhan, MD
• Denia International Drugs, Inc (International Drugs)
• Alexis Denmon
• Dennis Vega MD LLC
• Disha Desai
• Karan Desai, DO
• Ravi H Desai, PHARMD, RPH
• Riddhi Desai
• Naika Paulemie Desir, MD

• Dentist in Paterson, NJ
• Providers in Paterson, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.