Jersey Smile Dental, LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

22DI02322000 Issued in NJ

Legal business name

JERSEY SMILE DENTAL, LLC

Practice address

407 Main St
Spotswood, NJ 08884-1739

Phone

(732) 387-2360

Fax

(732) 387-2561

NPI assigned

Apr 28, 2014

Last updated

Apr 28, 2014By 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. Svetlana Konstantinova, D.D.S.

Title

Co-Owner/Dentist

Phone

(732) 387-2360

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1398643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398643200000",
    "number": "1982014114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 MAIN ST",
            "city": "SPOTSWOOD",
            "state": "NJ",
            "postal_code": "088841739",
            "telephone_number": "732-387-2360",
            "fax_number": "732-387-2561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 MAIN ST",
            "city": "SPOTSWOOD",
            "state": "NJ",
            "postal_code": "088841739",
            "telephone_number": "732-387-2360",
            "fax_number": "732-387-2561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY SMILE DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-28",
        "last_updated": "2014-04-28",
        "status": "A",
        "authorized_official_last_name": "KONSTANTINOVA",
        "authorized_official_first_name": "SVETLANA",
        "authorized_official_title_or_position": "CO-OWNER/DENTIST",
        "authorized_official_telephone_number": "732-387-2360",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NJ",
            "license": "22DI02322000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dental Clinic/Center in Spotswood, NJ
• Providers in Spotswood, NJ by specialty
• Dental Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; 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.