Healthcare Provider Details

I. General information

NPI: 1821294158
Provider Name (Legal Business Name): CHAD LAZAR D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 CAMPBELL DR
WILLINGBORO NJ
08046-1032
US

IV. Provider business mailing address

14 LANTERN LN
CHERRY HILL NJ
08002-1622
US

V. Phone/Fax

Practice location:
  • Phone: 609-877-1555
  • Fax:
Mailing address:
  • Phone: 856-482-0308
  • Fax: 856-667-5773

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number053385
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDS037112
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: