Family Dental Practice of New Jersey, LLC

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02524500 Issued in NJ

Legal business name

FAMILY DENTAL PRACTICE OF NEW JERSEY, LLC

Practice address

560 Newark Ave FL 2
Elizabeth, NJ 07208-3307

Phone

(908) 355-7800

Fax

(908) 355-7800

NPI assigned

Jul 18, 2017

Organization subpart

No

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

Authorized official

Name

Dr. Rene Osuala, DMD

Title

Owner

Phone

(908) 355-7800

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1500336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1500336000000",
    "number": "1952824310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 NEWARK AVE FL 2",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083307",
            "telephone_number": "908-355-7800",
            "fax_number": "908-355-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 NEWARK AVE FL 2",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083307",
            "telephone_number": "908-355-7800",
            "fax_number": "908-355-7800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DENTAL PRACTICE OF NEW JERSEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-18",
        "last_updated": "2017-07-18",
        "status": "A",
        "authorized_official_last_name": "OSUALA",
        "authorized_official_first_name": "RENE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "908-355-7800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02524500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Elizabeth, NJ
• Providers in Elizabeth, 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 18, 2017; 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.