Valley Dental Associates, PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

22DI00945900 Issued in NJ

Legal business name

VALLEY DENTAL ASSOCIATES, PA

Doing business as

Portale Dental

Practice address

555 Bergen Blvd
Ridgefield, NJ 07657-2020

Phone

(201) 945-5777

Fax

(201) 945-5667

NPI assigned

Mar 12, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Joseph John Portale, DMD

Title

Pres/Owner

Phone

(201) 945-5777

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Portale Dental Doing business as

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

{
    "created_epoch": "1394582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394582400000",
    "number": "1952727182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 BERGEN BLVD",
            "city": "RIDGEFIELD",
            "state": "NJ",
            "postal_code": "076572020",
            "telephone_number": "201-945-5777",
            "fax_number": "201-945-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 BERGEN BLVD",
            "city": "RIDGEFIELD",
            "state": "NJ",
            "postal_code": "076572020",
            "telephone_number": "201-945-5777",
            "fax_number": "201-945-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VALLEY DENTAL ASSOCIATES, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-12",
        "last_updated": "2014-03-12",
        "status": "A",
        "authorized_official_last_name": "PORTALE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRES/OWNER",
        "authorized_official_telephone_number": "201-945-5777",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NJ",
            "license": "22DI00945900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "22DI00945900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portale Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dental Clinic/Center in Ridgefield, NJ
• Providers in Ridgefield, NJ by specialty
• Dental Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; 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.