Garden State Smiles of Brick

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI021211 Issued in NJ

Legal business name

GARDEN STATE SMILES OF BRICK

Practice address

525 Route 70
Brick, NJ 08723

Phone

(732) 477-5770

NPI assigned

Mar 2, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Vlad Detinich, DMD

Title

President

Phone

(732) 322-9297

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456876800000",
    "number": "1992165088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 NEW JERSEY AVE # 70",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087241413",
            "telephone_number": "732-477-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 ROUTE 70",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "08723",
            "telephone_number": "732-477-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN STATE SMILES OF BRICK",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-02",
        "last_updated": "2016-03-02",
        "status": "A",
        "authorized_official_last_name": "DETINICH",
        "authorized_official_first_name": "VLAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "732-322-9297",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI021211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yu Yan Gao
• Jennifer Garcia, LCSW
• Vanessa Garcia
• Garden State Pain and Radiology Center 2, PC
• Garden State Smiles of Brick
• Emily Morgan Garelick
• Mary L. Garner, PT, DPT
• William Garry, PA-C
• Randi Gartner, DPT
• Gary a, Heubel, O.D.,P.a.

• General Practice Dentistry in Brick, NJ
• Providers in Brick, 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 Mar 2, 2016; 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.