Nj Team Dental Center Pa | |
2515 Hwy 516 Old Bridge NJ 08857 | |
(732) 679-3600 | |
(732) 679-2801 |
Full Name | Nj Team Dental Center Pa |
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Speciality | Dentist |
Location | 2515 Hwy 516, Old Bridge, New Jersey |
Authorized Official Name and Position | Andrew Scott Whiteman (PRESIDENT / DENTIST) |
Authorized Official Contact | 7326793600 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Nj Team Dental Center Pa 2515 Hwy 516 Old Bridge NJ 08857 Ph: (732) 679-3600 | Nj Team Dental Center Pa 2515 Hwy 516 Old Bridge NJ 08857 Ph: (732) 679-3600 |
NPI Number | 1942396833 |
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Provider Enumeration Date | 10/05/2006 |
Last Update Date | 08/22/2020 |
Medicare PECOS PAC ID | 2365757259 |
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Medicare Enrollment ID | O20150821013092 |
Identifier | Type | State | Issuer |
---|---|---|---|
1942396833 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
Provider Name | Takehiro Kasahara |
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Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1003023029 PECOS PAC ID: 4183778095 Enrollment ID: I20190910002835 |
Provider Name | Andrew S Whiteman |
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Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1932272333 PECOS PAC ID: 4688991615 Enrollment ID: I20240903000081 |
Provider Name | Alexander Lee |
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Provider Type | Practitioner - Oral Surgery |
Provider Identifiers | NPI Number: 1700089125 PECOS PAC ID: 9739498080 Enrollment ID: I20240904000010 |
Provider Name | Hyun Kim |
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Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1982192589 PECOS PAC ID: 4981135811 Enrollment ID: I20241003000501 |
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