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General NPI Number Information
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NPI Number | 1205745023
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Entity Type | Organization
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Legal Business Name | DEAR TOOTH FAIRY PEDIATRIC DENTISTRY & FAMILY ORTHODONTICS LLC
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Dates
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Enumeration Date | 09/07/2026
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Last Update Date | 09/07/2026
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Provider Practice Location Address
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Address Line | 414 GRAND ST STE 3
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City | JERSEY CITY
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State | NJ
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Zip | 07302-4240
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Country | US
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Telephone | 217-361-7647
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Fax |
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Provider Business Mailing Address
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Address Line | 94 BUENA VISTA AVE
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City | PISCATAWAY
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State | NJ
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Zip | 08854-4861
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Country | US
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Telephone | 217-361-7647
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. SARA FATIMA
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Credential | DDS
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Telephone | 217-361-7647
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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