NPIMap

Organization Active NPI

Lakeside Endodontics

  • Endodontics
  • Succasunna, NJ
National Provider Identifier
1972727253
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
22D101956300 Issued in NJ
Legal business name
LAKESIDE ENDODONTICS
Practice address
22 State Route 10 W
Suite 102
Succasunna, NJ 07876-1731
Phone
(973) 598-1600
Fax
(973) 598-1618
NPI assigned
Apr 11, 2007
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
Karen Ferraro
Title
Financial Coordinator
Phone
(973) 598-1600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X 22D101956300 NJ Primary

Addresses

Primary practice location

22 State Route 10 W
Suite 102
Succasunna, NJ 07876-1731

Mailing address

22 Route 10 West
Suite 102
Succasunna, NJ 07876
Phone (973) 598-1600

National Provider Directory

National Provider Directory

Locations

22 State Route 10 W
Ste 102
Succasunna, NJ 07876
Phone (973) 598-1600

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": "1176249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972727253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 ROUTE 10 WEST",
            "address_2": "SUITE 102",
            "city": "SUCCASUNNA",
            "state": "NJ",
            "postal_code": "07876",
            "telephone_number": "973-598-1600",
            "fax_number": "973-598-1618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 STATE ROUTE 10 W",
            "address_2": "SUITE 102",
            "city": "SUCCASUNNA",
            "state": "NJ",
            "postal_code": "078761731",
            "telephone_number": "973-598-1600",
            "fax_number": "973-598-1618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESIDE ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FERRARO",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "FINANCIAL COORDINATOR",
        "authorized_official_telephone_number": "973-598-1600"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "NJ",
            "license": "22D101956300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Succasunna, 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.