Riverside Oral Surgery-River Edge

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

RIVERSIDE ORAL SURGERY-RIVER EDGE

Practice address

130 Kinderkamack Rd
Suite 204
River Edge, NJ 07661-1939

Phone

(201) 487-6565

Fax

(201) 487-4229

NPI assigned

Nov 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jason Michael Auerbach, DDS

Title

Owner

Phone

(201) 487-6565

Specialties & licenses 1

Addresses

Other names 1

• Riverside Oral Surgery Other name

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

{
    "created_epoch": "1194998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473206400000",
    "number": "1962683334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 KINDERKAMACK RD",
            "address_2": "SUITE 204",
            "city": "RIVER EDGE",
            "state": "NJ",
            "postal_code": "076611939",
            "telephone_number": "201-487-6565",
            "fax_number": "201-487-4229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 KINDERKAMACK RD",
            "address_2": "SUITE 204",
            "city": "RIVER EDGE",
            "state": "NJ",
            "postal_code": "076611939",
            "telephone_number": "201-487-6565",
            "fax_number": "201-487-4229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE ORAL SURGERY-RIVER EDGE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-14",
        "last_updated": "2016-09-07",
        "status": "A",
        "authorized_official_last_name": "AUERBACH",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-487-6565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Riverside Oral Surgery",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in River Edge, NJ
• Providers in River Edge, NJ by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.