Healthcare Provider Details

I. General information

NPI: 1295195998
Provider Name (Legal Business Name): S MERRIMAN D.D.S.,P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2016
Last Update Date: 02/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229 CHARLES ST
WESTFIELD NJ
07090-4026
US

IV. Provider business mailing address

229 CHARLES ST
WESTFIELD NJ
07090-4026
US

V. Phone/Fax

Practice location:
  • Phone: 908-389-0222
  • Fax:
Mailing address:
  • Phone: 908-389-0222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State

VIII. Authorized Official

Name: DR. SUNITA MERRIMAN
Title or Position: OWNER
Credential:
Phone: 908-389-0222