Healthcare Provider Details

I. General information

NPI: 1659196269
Provider Name (Legal Business Name): BRIGHTVIEW DENTAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 11/19/2024
Certification Date: 11/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 36TH ST
UNION CITY NJ
07087-4712
US

IV. Provider business mailing address

402 36TH ST
UNION CITY NJ
07087-4712
US

V. Phone/Fax

Practice location:
  • Phone: 201-866-3299
  • Fax:
Mailing address:
  • Phone: 201-866-3299
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. IQRA AHMED
Title or Position: PRESIDENT
Credential: DMD
Phone: 201-850-3612