Ridgewood Dental Group LLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

RIDGEWOOD DENTAL GROUP LLC

Practice address

75 Chestnut St
Ridgewood, NJ 07450-2501

Phone

(201) 445-4808

Fax

(201) 445-2040

NPI assigned

Jan 18, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Warren Boardman, DMD

Title

Dentist

Phone

(201) 445-1060

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1200614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380758400000",
    "number": "1992981062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 CHESTNUT ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074502501",
            "telephone_number": "201-445-4808",
            "fax_number": "201-445-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 CHESTNUT ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074502501",
            "telephone_number": "201-445-4808",
            "fax_number": "201-445-2040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDGEWOOD DENTAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-18",
        "last_updated": "2013-10-03",
        "status": "A",
        "authorized_official_last_name": "BOARDMAN",
        "authorized_official_first_name": "WARREN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "201-445-1060",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ridgewood Ambulatory Surgery Center
• Ridgewood Board of Education
• Ridgewood Chiropractic
• Ridgewood Corset Shop Inc
• Ridgewood Dental Associates, LLC
• Ridgewood Dentistry, LLC (Glenn P Godart)
• Ridgewood ENT & Dermatology
• Ridgewood Eye Care & Wear LLC
• Ridgewood Foot Center
• Ridgewood House of Wellness LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2013; 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.