Healthcare Provider Details

I. General information

NPI: 1831029040
Provider Name (Legal Business Name): BOONTON DENTAL HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/20/2026
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 W MAIN ST
BOONTON NJ
07005-1166
US

IV. Provider business mailing address

19 S ROCKAWAY DR
BOONTON NJ
07005-9185
US

V. Phone/Fax

Practice location:
  • Phone: 510-894-5585
  • Fax:
Mailing address:
  • Phone: 510-894-5585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: MRS. NIVEDITHA SAROF
Title or Position: OWNER
Credential: DDS
Phone: 510-894-5585