Bergenfield Dental Associates

Primary specialty

DentistTaxonomy code 122300000X

License

DI17120 Issued in NJ

Legal business name

BERGENFIELD DENTAL ASSOCIATES

Practice address

29 W Church St
Bergenfield, NJ 07621-1703

Phone

(201) 384-0100

Fax

(201) 384-3558

NPI assigned

Apr 13, 2007

Last updated

Sep 16, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ehab Tanios Shahid, D.M.D.NPI 1265553838

Title

President

Phone

(201) 384-0100

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ehab Tanios Shahid, DMD

  • General Practice Dentistry
  • Bergenfield, NJ
  • NPI 1265553838
  NPD (past) Authorized official

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1972727345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 W CHURCH ST",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076211703",
            "telephone_number": "201-384-0100",
            "fax_number": "201-384-3558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 W CHURCH ST",
            "city": "BERGENFIELD",
            "state": "NJ",
            "postal_code": "076211703",
            "telephone_number": "201-384-0100",
            "fax_number": "201-384-3558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BERGENFIELD DENTAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "SHAHID",
        "authorized_official_first_name": "EHAB",
        "authorized_official_middle_name": "TANIOS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-384-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI17120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bergen Dental Practice, P.C.
• Bergen Pediatric Center,P.C
• Bergen Spine & Rehabilitation, LLC
• Bergen Spine Sport & Rehab LLC
• Bergenfield Board of Education
• Bergenfield Gynecology & Wellness LLC
• Bergenfield Internal Medicine, L.L.C. (Michael A. DeGennaro, M.D.)
• Bergenfield Medical Arts, PA
• Bergenfield Medical Clinic Inc (Dasmd Clinic)
• Bergenfield Oral Surgery Associates LLC

• Dentist in Bergenfield, NJ
• Providers in Bergenfield, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; 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.