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1598037996 NPI number — STRONG ROOTS DENTAL PC

NPI Number: 1598037996
Health Care Provider/Practitioner: STRONG ROOTS DENTAL PC

Information about “1598037996” NPI (STRONG ROOTS DENTAL PC) exists in 1598037996 in HTML format HTML  |  1598037996 in plain Text format TXT  |  1598037996 in PDF (Portable Document Format) PDF  |  1598037996 in an XML format XML  formats.

NPI Number : 1598037996 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1598037996",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "STRONG ROOTS DENTAL PC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "273 NEWARK AVENUE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "JERSEY CITH",
    "MailingAddressStateName": "NJ",
    "MailingAddressPostalCode": "07302",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "551-200-6002",
    "MailingAddressFaxNumber": "201-984-0607",
    "FirstLinePracticeLocationAddress": "273 NEWARK AVENUE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JERSEY CITH",
    "PracticeLocationAddressStateName": "NJ",
    "PracticeLocationAddressPostalCode": "07302",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "551-200-6002",
    "PracticeLocationAddressFaxNumber": "201-984-0607",
    "EnumerationDate": "01/31/2012",
    "LastUpdateDate": "02/28/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "JUAREZ",
    "AuthorizedOfficialFirstName": "JAHAYRA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OFFICE MANAGER",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "551-200-6002",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "1223G0001X",
          "TaxonomyName": "General Practice Dentistry",
          "LicenseNumber": "22DIO2449200",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "1223G0001X",
          "TaxonomyName": "General Practice Dentistry",
          "LicenseNumber": "22DI02410701",
          "LicenseNumberStateCode": "NJ",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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