Healthcare Provider Details
I. General information
NPI: 1558312181
Provider Name (Legal Business Name): RICHARD P SZUMITA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/16/2006
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
310 PASSAIC AVE STE 203
FAIRFIELD NJ
07004-2523
US
IV. Provider business mailing address
310 PASSAIC AVE STE 203
FAIRFIELD NJ
07004-2523
US
V. Phone/Fax
- Phone: 973-256-0103
- Fax: 973-291-2827
- Phone: 973-256-0103
- Fax: 973-291-2827
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 204E00000X |
| Taxonomy | Oral & Maxillofacial Surgery (D.M.D.) |
| License Number | DI01843000 |
| License Number State | NJ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 1223S0112X |
| Taxonomy | Oral and Maxillofacial Surgery (Dentist) |
| License Number | DI 18430 |
| License Number State | NJ |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223S0112X |
| Taxonomy | Oral and Maxillofacial Surgery (Dentist) |
| License Number | DI01843000 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: