Healthcare Provider Details

I. General information

NPI: 1780966317
Provider Name (Legal Business Name): AMERICARE DENTAL P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2011
Last Update Date: 09/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6418 BERGENLINE AVE
WEST NEW YORK NJ
07093-1621
US

IV. Provider business mailing address

6418 BERGENLINE AVE
WEST NEW YORK NJ
07093-1621
US

V. Phone/Fax

Practice location:
  • Phone: 201-868-6400
  • Fax: 201-868-6689
Mailing address:
  • Phone: 201-868-6400
  • Fax: 201-868-6689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI02347800
License Number StateNJ

VIII. Authorized Official

Name: DR. AMISH PATEL
Title or Position: OWNER
Credential: DMD
Phone: 267-221-9898