MEDICARE: IVN DENTAL LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1861359689
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IVN DENTAL LLC

Provider Business Mailing Address
First Line	:	77 VALLEY RD
Second Line	:
City	:	CLARK
State	:	NJ
Zip	:	07066-1811
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	77 VALLEY RD
Second Line	:
City	:	CLARK
State	:	NJ
Zip	:	07066-1811
Country	:	US
Telephone Number	:	201-637-2054
Fax Number	:

Authorized Official
Title or Position	:	DR.
Name	:	IVAN ALKHWEKHI
Credential	:	DMD
Telephone Number	:	201-637-2054

Provider Enumeration Date	:	01/05/2026
Last Update Date	:	01/05/2026

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