Barry E Ettelson DDS PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

08424 Issued in NJ

Legal business name

BARRY E ETTELSON DDS PA

Practice address

900 Route 168 Ste I6
Washington Professional Campus
Turnersville, NJ 08012-3212

Phone

(856) 227-2554

Fax

(856) 227-4066

NPI assigned

Feb 6, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Barry E Ettelson, DDS

Title

President Dentist

Phone

(856) 227-2554

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982743944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ROUTE 168 STE I6",
            "address_2": "WASHINGTON PROFESSIONAL CAMPUS",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080123212",
            "telephone_number": "856-227-2554",
            "fax_number": "856-227-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 ROUTE 168 STE I6",
            "address_2": "WASHINGTON PROFESSIONAL CAMPUS",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080123212",
            "telephone_number": "856-227-2554",
            "fax_number": "856-227-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARRY E ETTELSON DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ETTELSON",
        "authorized_official_first_name": "BARRY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT DENTIST",
        "authorized_official_telephone_number": "856-227-2554",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "08424",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "D5015997L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Baker, APN-C
• Demi Banchs, LPC
• Herman Tom Barb, MD
• Amy Barker, APN
• Laura Barnes, OTR/L
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• Julia Lynne Bell
• Catherine Marie Benedict, LCSW

• General Practice Dentistry in Turnersville, NJ
• Providers in Turnersville, NJ by specialty
• General Practice Dentistry in New Jersey

• 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.