Healthcare Provider Details

I. General information

NPI: 1336214592
Provider Name (Legal Business Name): HAMILTON DENTAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 03/14/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2929 KLOCKNER RD
HAMILTON SQUARE NJ
08690-2809
US

IV. Provider business mailing address

2929 KLOCKNER RD
HAMILTON SQUARE NJ
08690-2809
US

V. Phone/Fax

Practice location:
  • Phone: 609-586-6603
  • Fax: 609-528-3003
Mailing address:
  • Phone: 609-586-6603
  • Fax: 609-586-1801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number2143801
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14326
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number8446
License Number StateNJ
# 4
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number12030
License Number StateNJ
# 5
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number21989
License Number StateNJ
# 6
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. SIDNEY WHITMAN
Title or Position: DENTIST-
Credential: DDS
Phone: 609-586-6603