Healthcare Provider Details

I. General information

NPI: 1861920563
Provider Name (Legal Business Name): DARIUS ORTHODONTICS OF CALDWELL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 BLOOMFIELD AVE
CALDWELL NJ
07006-5309
US

IV. Provider business mailing address

47 BLOOMFIELD AVE
CALDWELL NJ
07006-5309
US

V. Phone/Fax

Practice location:
  • Phone: 973-396-0150
  • Fax:
Mailing address:
  • Phone: 973-396-0150
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number22DI02360200
License Number StateNJ

VIII. Authorized Official

Name: DR. DARYOUSH HAGHIGHI
Title or Position: OWNER
Credential: DDS
Phone: 973-396-0150