Healthcare Provider Details

I. General information

NPI: 1790618478
Provider Name (Legal Business Name): NEW BRIGHTER SMILES DENTAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

242 WASHINGTON AVE STE D
NUTLEY NJ
07110-1956
US

IV. Provider business mailing address

19 FAIRVIEW PL
MONTCLAIR NJ
07043-2318
US

V. Phone/Fax

Practice location:
  • Phone: 973-667-1567
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: DR. PRASANNA SAIREDDY
Title or Position: OWNER
Credential: DDS
Phone: 973-667-1567