Healthcare Provider Details

I. General information

NPI: 1942422233
Provider Name (Legal Business Name): JEFFREY S. SACHS, D.M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

812 POOLE AVE SUITE E
HAZLET NJ
07730-2024
US

IV. Provider business mailing address

812 POOLE AVE SUITE E
HAZLET NJ
07730-2024
US

V. Phone/Fax

Practice location:
  • Phone: 732-739-0900
  • Fax: 732-739-9597
Mailing address:
  • Phone: 732-739-0900
  • Fax: 732-739-9597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI01610100
License Number StateNJ

VIII. Authorized Official

Name: DR. JEFFREY SCOTT SACHS
Title or Position: OWNER
Credential: D.M.D.
Phone: 732-739-0900