NPIMap

Organization Active NPI

Tender Smiles 4 Kids of Monmouth, LLC

  • Pediatric Dentistry
  • Freehold, NJ
National Provider Identifier
1942315445
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
21205 Issued in NJ
Legal business name
TENDER SMILES 4 KIDS OF MONMOUTH, LLC
Practice address
4249 US Highway 9
BLDG 2 Suite a
Freehold, NJ 07728-8308
Phone
(732) 625-8080
Fax
(732) 625-8003
NPI assigned
Aug 21, 2006
Last updated
Aug 22, 2020By the provider in NPPES
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
Maxim Sulla, D.D.S.
Title
Owner
Phone
(732) 625-8080

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X 21205 NJ Primary

Addresses

Primary practice location

4249 US Highway 9
BLDG 2 Suite a
Freehold, NJ 07728-8308

Mailing address

4249 US Highway 9
BLDG 2 Suite a
Freehold, NJ 07728-8308
Phone (732) 625-8080

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942315445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4249 US HIGHWAY 9",
            "address_2": "BLDG 2 SUITE A",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077288308",
            "telephone_number": "732-625-8080",
            "fax_number": "732-625-8003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4249 US HIGHWAY 9",
            "address_2": "BLDG 2 SUITE A",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077288308",
            "telephone_number": "732-625-8080",
            "fax_number": "732-625-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENDER SMILES 4 KIDS OF MONMOUTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SULLA",
        "authorized_official_first_name": "MAXIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-625-8080",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "21205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, 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.