Healthcare Provider Details

I. General information

NPI: 1275326274
Provider Name (Legal Business Name): TZVI KRUPKA DDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2025
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 ANNABELLE AVE
CLIFTON NJ
07012-1805
US

IV. Provider business mailing address

5 ANNABELLE AVE
CLIFTON NJ
07012-1805
US

V. Phone/Fax

Practice location:
  • Phone: 973-934-3657
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State

VIII. Authorized Official

Name: TZVI KRUPKA
Title or Position: OWNER
Credential: DDS
Phone: 973-934-3657