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EASTERN PERIODONTIC ASSOCIATES LLC NPI 1093876658


NPI Information

NPI: 1093876658
Provider Name: EASTERN PERIODONTIC ASSOCIATES, LLC
Classification: Dentist - 1223P0300X
Entity Type: Organization

Specialization: Periodontics

Address:
1030 SAINT GEORGES AVE
AVENEL, NJ
ZIP 07001
Phone: (732) 750-3600
Get Directions

EASTERN PERIODONTIC ASSOCIATES, LLC is a periodontics dentist in Avenel, NJ. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. EASTERN PERIODONTIC ASSOCIATES, LLC NPI is 1093876658. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1030 SAINT GEORGES AVE
AVENEL, NJ
ZIP 07001-390
Phone: (732) 750-3600
Fax: (732) 750-3696

The provider's authorized official is Aaron Prestup .
The authorized official title is Director Of Periodontics and has the following contact phone number (732) 750-3600.

The enumeration date for this NPI number is 12/13/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0300XDentistPeriodontics09460NEW JERSEYYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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