Organization Active NPI

Visiting Dental PC

  • General Practice Dentistry
  • Glen Rock, NJ
National Provider Identifier
1992993133
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
VISITING DENTAL PC
Practice address
39 Wellesley Rd
Glen Rock, NJ 07452-1222
Phone
(201) 670-0097
Fax
(201) 445-0225
NPI assigned
Oct 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Authorized official

Name
Mrs. Robin Schoenberg
Title
Office Manager
Phone
(201) 670-0097

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

39 Wellesley Rd
Glen Rock, NJ 07452-1222

Mailing address

39 Wellesley Rd
Glen Rock, NJ 07452-1222
Phone (201) 670-0097

Other identifiers 1

IdentifierTypeStateIssuer
6882803MedicaidNJ

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1992993133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 WELLESLEY RD",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074521222",
            "telephone_number": "201-670-0097",
            "fax_number": "201-445-0225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 WELLESLEY RD",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074521222",
            "telephone_number": "201-670-0097",
            "fax_number": "201-445-0225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISITING DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-12",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "SCHOENBERG",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "201-670-0097",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6882803",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Rock, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; 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.