MEDICARE: DR. KENNETH WILLIAM ARIDA DDS

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	14392	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	223477168	OTHER	NJ	TAX ID#

General Provider Information

NPI Number	:	1760559967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH WILLIAM ARIDA DDS

Provider Business Mailing Address
First Line	:	131 S EUCLID AVE
Second Line	:
City	:	WESTFIELD
State	:	NJ
Zip	:	07090-2129
Country	:	US
Telephone Number	:	908-654-6262
Fax Number	:	908-654-0151

Provider Business Practice Location Address
First Line	:	131 S EUCLID AVE
Second Line	:
City	:	WESTFIELD
State	:	NJ
Zip	:	07090-2129
Country	:	US
Telephone Number	:	908-654-6262
Fax Number	:	908-654-0151

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/30/2006
Last Update Date	:	07/08/2007

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