Pearly Whites PA

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

22DI02353601 Issued in NJ

Legal business name

PEARLY WHITES PA

Practice address

501 Springfield Ave FL 2
Berkeley Heights, NJ 07922-1180

Phone

(908) 464-6789

Fax

(908) 464-6767

NPI assigned

Mar 5, 2013

Organization subpart

No

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

Authorized official

Name

Michael Skolnick, DMD

Title

President

Phone

(908) 464-6789

Specialties & licenses 6

Addresses

Tax ID family

Abra Dental2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Pearly Whites Professional Association

  dba Abra Dental

  • General Practice Dentistry
  • Berkeley Heights, NJ
  • NPI 1437012861
  NPD tax ID

Locations

Practitioners 2

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

• Jennifer Lasasso, DMD

  • Dentist
  • Berkeley Heights, NJ
  • NPI 1114156205
  NPD (past)
• Janet Mark

  • Dentist
  • Newark, NJ
  • NPI 1205324555

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1362441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582588800000",
    "number": "1942541677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 SPRINGFIELD AVE",
            "address_2": "2ND FLOOR",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079221180",
            "telephone_number": "908-464-6789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 SPRINGFIELD AVE FL 2",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079221180",
            "telephone_number": "908-464-6789",
            "fax_number": "908-464-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEARLY WHITES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-05",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A",
        "authorized_official_last_name": "SKOLNICK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-464-6789",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Endodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02349301",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "22DI02353601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Doliner, M.D.,P.C.
• Julia Shelkey Pavelic, M.D.
• Martin Thomas Pavelic III, M.D.
• Peace of Mind Counseling and Wellness Center
• Peak Medical, LLC
• Pearly Whites Professional Association (Abra Dental)
• Pearly Whites Spec LLC (Pearly Whites)
• Pediatric Speech, Language, & Learning Center, LLC
• Ryan Pelcher, D.M.D
• Astaire Perez, PT, DPT

• Orthodontics and Dentofacial Orthopedics Dentistry in Berkeley Heights, NJ
• Providers in Berkeley Heights, NJ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.