Healthcare Provider Details

I. General information

NPI: 1093620262
Provider Name (Legal Business Name): LYNDHURST FAMILY DENTAL ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

464 VALLEY BROOK AVE FL 2A
LYNDHURST NJ
07071-1995
US

IV. Provider business mailing address

464 VALLEY BROOK AVE FL 2A
LYNDHURST NJ
07071-1995
US

V. Phone/Fax

Practice location:
  • Phone: 201-933-9092
  • Fax: 201-932-0112
Mailing address:
  • Phone: 201-933-9092
  • Fax: 201-932-0112

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: JOHN K LEE
Title or Position: DMD OWNER
Credential:
Phone: 201-933-9092