EASTERN DENTAL OF VINELAND, LLC (NPI# 1033236625) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033236625 |
| Entity Type | Organization |
| Organization Name | EASTERN DENTAL OF VINELAND, LLC |
| Practice Address |
1145 E Chestnut Ave Vineland NJ 08360-5001 |
| Mailing Address |
1030 Saint Georges Ave Avenel NJ 07001-1390 |
| Practice Telephone | 8566925400 |
| Enumeration Date | 2007-03-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MICHAEL BUNDY (DIRECTOR) |
| Authorized Official Telephone | 8566925400 |
| Authorized Official Credential | D.M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 1223G0001X |
Dentist Specialization: General Practice |
22761 | NJ | Dental Providers |
| X | 1223P0300X |
Dentist Specialization: Periodontics |
09460 | NJ | Dental Providers |
| X | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
07879 | NJ | Dental Providers |
| X | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
23068 | NJ | Dental Providers |
| Street Address |
1145 E CHESTNUT AVE |
| City | VINELAND |
| State | NJ |
| Zip Code | 08360-5001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104486315 | Ameer Najah Hadi Hadi | Dentist | 1145 E Chestnut Ave, Vineland, NJ 08360-5001 | 2019-06-19 |
| 1841781754 | Anam Tariq | Dentist | 1145 E Chestnut Ave, Vineland, NJ 08360 | 2018-05-25 |
| 1891216784 | Christine Hernandez | Dentist | 1145 E Chestnut Ave, Vineland, NJ 08360-5001 | 2017-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215534748 | Lindsay Gibbons | Social Worker | 60 W Ave, Vineland, NJ 08360 | 2020-10-07 |
| 1033769849 | Buena Vista Township Emergency Medical Services Inc. | Ambulance | 4931 E. Landis Ave., Vineland, NJ 08360 | 2019-09-13 |
| 1669037636 | Elwyn New Jersey | Day Training, Developmentally Disabled Services | Elwyn New Jersey Supported Employment Small Group, 228 W. Landis Avenue, Suite 302, Vineland, NJ 08360 | 2019-05-06 |
| 1972001519 | Kyle James Knowles | Physician Assistant | 1138 East Chestnut Avenue, Building 8 Suite B, Vineland, NJ 08360 | 2018-01-29 |
| 1205346574 | Maryville, Inc | Clinic/Center | 1173 E Landis Ave, Vineland, NJ 08360 | 2017-10-02 |
| 1184147043 | Sarah Lee | Pharmacist | 75 W Landis Ave, Vineland, NJ 08360 | 2017-07-24 |
| 1780111419 | Elwyn New Jersey | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 30 D'shibe Terrace, Vineland, NJ 08360 | 2017-05-12 |
| 1528414810 | Khushbu V Janani | Internal Medicine | 1505 W Sherman Avenue, Inspira Health Network, Vineland, NJ 08360 | 2016-05-05 |
| 1669841409 | University Womens Imaging LLC | Clinic/Center | 1051 West Sherman Avenue, Suite 4a, Vineland, NJ 08360 | 2015-09-23 |
| 1710369350 | Elwyn New Jersey | Day Training, Developmentally Disabled Services | 46 N West Ave, Building A, Vineland, NJ 08360 | 2015-06-19 |
| Find all providers in zip 08360 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134461015 | Paul John Marcucci Jr. | Dentist | 556 N Harding Hwy, Vineland, NJ 08360-8713 | 2013-03-19 |
| 1629329925 | Affordable Dentures - Vineland, Michelle Aitken, Dds., P.a. | Dentist | 60 W Landis Ave, Vineland, NJ 08360-8107 | 2012-09-26 |
| 1679706543 | Steven L. Rasner, Dmd, Magd | Dentist | 2106 W Landis Ave, Vineland, NJ 08360-3431 | 2009-08-26 |
| 1922257047 | Robert Henry Carlson | Dentist | 435 W Landis Ave, Vineland, NJ 08360-8105 | 2008-09-12 |
| 1396910519 | Joel Peter Agranoff | Dentist | 411 S West Ave, Vineland, NJ 08360-5248 | 2008-04-29 |
| 1578766747 | Steven Philip Weinberg | Dentist | 1725 Wynnewood Dr, Vineland, NJ 08361-6753 | 2007-06-06 |
| 1083827430 | Dentofacial Associates,pa | Dentist | 435 W. Landis Avenue, Vineland, NJ 08360 | 2007-05-08 |
| 1861604167 | William F. Dudley | Dentist | 1051 Magnolia Rd, Vineland, NJ 08360-6422 | 2007-05-07 |
| 1710002944 | Mark Giorno Dmd & Associate Pa | Dentist | 2581 E Chestnut Ave, Suite A, Vineland, NJ 08361-8487 | 2007-03-20 |
| 1326120569 | Jessica Baker | Dentist | 70 S State St, Vineland, NJ 08360-4851 | 2006-10-19 |
| Find all providers in VINELAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.