NPIMap

Organization Active NPI

Pediatric Dental Associates of South Jersey, PA

  • Pediatric Dentistry
  • Cherry Hill, NJ
National Provider Identifier
1972532158
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
NJ8986 Issued in NJ
Legal business name
PEDIATRIC DENTAL ASSOCIATES OF SOUTH JERSEY, PA
Practice address
401 Kings Hwy S
4B
Cherry Hill, NJ 08034-2500
Phone
(856) 429-2225
NPI assigned
Jul 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Robert P Gersh, D.M.D.NPI 1124237334
Title
Partner/Dentist
Phone
(856) 429-2225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X NJ8986 NJ Primary
Pediatric DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223P0221X NJ21760 NJ

Addresses

Primary practice location

401 Kings Hwy S
4B
Cherry Hill, NJ 08034-2500

Mailing address

401 Kings Hwy S
4B
Cherry Hill, NJ 08034-2500
Phone (856) 429-2225

Other names 1

  • Pediatric Dental Associates Other name

National Provider Directory

National Provider Directory

Locations

401 Kings Hwy S
Ste 4B
Cherry Hill, NJ 08034
Phone (856) 429-2225

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1151712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972532158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 KINGS HWY S",
            "address_2": "4B",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342500",
            "telephone_number": "856-429-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 KINGS HWY S",
            "address_2": "4B",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342500",
            "telephone_number": "856-429-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC DENTAL ASSOCIATES OF SOUTH JERSEY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GERSH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PARTNER/DENTIST",
        "authorized_official_telephone_number": "856-429-2225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "NJ8986",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "NJ21760",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pediatric Dental Associates",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.