Healthcare Provider Details

I. General information

NPI: 1790608818
Provider Name (Legal Business Name): AESTHETIC SMILE AND IMPLANT STUDIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MOUNT PLEASANT AVE STE E SUITE E
DOVER NJ
07801-1630
US

IV. Provider business mailing address

600 MOUNT PLEASANT AVE STE E SUITE E
DOVER NJ
07801-1630
US

V. Phone/Fax

Practice location:
  • Phone: 973-361-6200
  • Fax: 973-361-4744
Mailing address:
  • Phone: 973-361-6200
  • Fax: 973-361-4744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: ALENA BARYSENKA
Title or Position: DOCTOR
Credential:
Phone: 973-361-6200