MEDICARE: BAYVILLE DENTAL ARTS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1114756095
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BAYVILLE DENTAL ARTS

Provider Business Mailing Address
First Line	:	800 ATLANTIC CITY BLVD STE 1
Second Line	:
City	:	BAYVILLE
State	:	NJ
Zip	:	08721-3068
Country	:	US
Telephone Number	:	732-269-3200
Fax Number	:

Provider Business Practice Location Address
First Line	:	800 ATLANTIC CITY BLVD STE 1
Second Line	:
City	:	BAYVILLE
State	:	NJ
Zip	:	08721-3068
Country	:	US
Telephone Number	:	732-269-3200
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JAMIE OSHIDAR
Credential	:	DMD
Telephone Number	:	609-752-2408

Provider Enumeration Date	:	07/30/2024
Last Update Date	:	08/20/2024

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