Healthcare Provider Details

I. General information

NPI: 1982605952
Provider Name (Legal Business Name): ALAN ROTHSTEIN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2005
Last Update Date: 03/31/2021
Certification Date: 03/31/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 E NORTHFIELD RD SUITE 2D
LIVINGSTON NJ
07039-4896
US

IV. Provider business mailing address

315 E NORTHFIELD RD SUITE 2E
LIVINGSTON NJ
07039-4896
US

V. Phone/Fax

Practice location:
  • Phone: 973-625-1491
  • Fax: 973-625-1319
Mailing address:
  • Phone: 973-625-1491
  • Fax: 973-625-1319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number043124
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDI019452
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: