NJ DFC Orthodontics, LLC

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

Legal business name

NJ DFC ORTHODONTICS, LLC

Practice address

870 River Ave
Lakewood, NJ 08701-5280

Phone

(484) 787-2946

NPI assigned

Aug 24, 2021

Organization subpart

Yes

Parent organization

NJ DENTISTRY FOR CHILDREN, P.A.As reported in NPPES

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

Authorized official

Name

Phi Le

Title

Credentialing Contracts Manager

Phone

(267) 575-2321

Specialties & licenses 1

Addresses

Part of

Ocean Family Dental

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• NJ Dentistry for Children, P.a.

  • Pediatric Dentistry
  • Lakewood, NJ
  • NPI 1730330663
  NPPES parent name

Practitioners 2

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

• Bridget E Henn, D.D.S

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Jackson, NJ
  • NPI 1689938615
  NPD (past)
• Ambica Mallipeddi, DDS

  • Pediatric Dentistry
  • Jackson, NJ
  • NPI 1467045518

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1942977491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 WILLOWBROOK LN STE 330",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193825594"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "870 RIVER AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015280",
            "telephone_number": "484-787-2946"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21 S Hope Chapel Rd Unit 133-135",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "NJ",
            "postal_code": "085275000",
            "country_code": "US",
            "telephone_number": "732-813-3730",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1256 Indian Head Rd Unit 16-18",
            "address_purpose": "LOCATION",
            "city": "Toms River",
            "state": "NJ",
            "postal_code": "087554075",
            "country_code": "US",
            "telephone_number": "732-240-2244",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1944 Corlies Avenue",
            "address_2": "Unit 101B",
            "address_purpose": "LOCATION",
            "city": "Neptune City",
            "state": "NJ",
            "postal_code": "07753",
            "country_code": "US",
            "telephone_number": "732-776-3560",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5315 US Highway 9",
            "address_purpose": "LOCATION",
            "city": "Howell",
            "state": "NJ",
            "postal_code": "077313753",
            "country_code": "US",
            "telephone_number": "732-378-9990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NJ DFC ORTHODONTICS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NJ DENTISTRY FOR CHILDREN, P.A.",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-04",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "PHI",
        "authorized_official_title_or_position": "CREDENTIALING CONTRACTS MANAGER",
        "authorized_official_telephone_number": "267-575-2321"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Lakewood, NJ
• Providers in Lakewood, 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 Aug 24, 2021; 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.