Healthcare Provider Details

I. General information

NPI: 1417637380
Provider Name (Legal Business Name): EMD ENGLEWOOD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 07/24/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 ENGLE ST
ENGLEWOOD NJ
07631-1829
US

IV. Provider business mailing address

323 E MADISON AVE
CRESSKILL NJ
07626-1743
US

V. Phone/Fax

Practice location:
  • Phone: 201-501-8282
  • Fax:
Mailing address:
  • Phone: 201-981-1260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. NARPAT S JAIN
Title or Position: MEMBER
Credential: DMD
Phone: 201-501-8282