Healthcare Provider Details

I. General information

NPI: 1417436205
Provider Name (Legal Business Name): JOHN OGARA DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2018
Last Update Date: 09/09/2021
Certification Date: 08/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2936 NJ-10
MORRIS PLAINS NJ
07950
US

IV. Provider business mailing address

808 RIVERVALE RD
RIVER VALE NJ
07675-6122
US

V. Phone/Fax

Practice location:
  • Phone: 862-345-7897
  • Fax:
Mailing address:
  • Phone: 775-223-4927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12267
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22DI02858500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: