Healthcare Provider Details

I. General information

NPI: 1972252062
Provider Name (Legal Business Name): EMILY SCHUPP DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2022
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BRIDGE PLAZA DR
MANALAPAN NJ
07726-1729
US

IV. Provider business mailing address

200 BRIDGE PLAZA DR
MANALAPAN NJ
07726-1729
US

V. Phone/Fax

Practice location:
  • Phone: 732-880-0404
  • Fax:
Mailing address:
  • Phone: 732-880-0404
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI02933400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: