Healthcare Provider Details

I. General information

NPI: 1700917127
Provider Name (Legal Business Name): RYAN ZLOTKOWSKI DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 NEWARK POMPTON TPKE
RIVERDALE NJ
07457-1186
US

IV. Provider business mailing address

27 NEWARK POMPTON TPKE STE 1
RIVERDALE NJ
07457-1187
US

V. Phone/Fax

Practice location:
  • Phone: 973-835-0702
  • Fax:
Mailing address:
  • Phone: 973-835-0702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number22D102289100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: