DIVINE DENTAL LLC (NPI# 1336772664) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336772664 |
| Entity Type | Organization |
| Organization Name | DIVINE DENTAL LLC |
| Practice Address |
485 S Washington Ave Bergenfield NJ 07621-4313 |
| Practice Telephone | 2013458881 |
| Mailing Telephone | 2013458881 |
| Enumeration Date | 2020-02-14 |
| Last Update Date | 2020-02-14 |
| Authorized Official Name | JAMES KANG (OWNER) |
| Authorized Official Telephone | 2013458881 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers | ||
| Y | 122300000X | Dentist | Dental Providers |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Divine Dental LLC | 1013 South Federal Boulevard, Denver, CO 80219-4101 |
| Street Address |
485 S WASHINGTON AVE |
| City | BERGENFIELD |
| State | NJ |
| Zip Code | 07621-4313 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245649680 | James Y Kang | Dentist | 485 S Washington Ave, Bergenfield, NJ 07621-4313 | 2014-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669952115 | Sublime Therapy | Massage Therapist | 80 N Washington Ave, Unite L4, Bergenfield, NJ 07621 | 2018-08-15 |
| 1619487824 | Perseverance A Okai Adjetey | Registered Nurse | 23 Lake Street, Bergenfield, NJ 07621 | 2017-10-03 |
| 1285144469 | Stacie Lynn Morvay | Nurse Practitioner | 129 Liberty Rd Apt B, Bergenfield, NJ 07621 | 2017-10-02 |
| 1295254308 | Keren Nussbaum | Speech-Language Pathologist | 60 Glenwood Drive S, Bergenfield, NJ 07621 | 2017-09-11 |
| 1538608450 | Lcn Medical Group | Internal Medicine | 136 N. Washington Ave. Suite 201, Bergenfield, NJ 07621 | 2017-02-13 |
| 1154782969 | Martine Meleance | Counselor | 386 West Main St, Berganfield, NJ 07621 | 2016-03-08 |
| 1609257591 | Maria C. Stone, Lcsw, LLC | Social Worker | 29 Legion Drive, Bergenfield, NJ 07621 | 2015-06-16 |
| 1003219536 | Ismile Dental Associates | Dentist | 22 N Washington Ave., Bergenfield, NJ 07621 | 2014-09-29 |
| 1710399415 | Maria Rena Penecilla | Registered Nurse | 74 Madison Ave, Bergenfield, NJ 07621 | 2014-05-29 |
| 1619394954 | Russell L Sadang | Physical Therapist | 103 Carnation St, Bergenfield, NJ 07621 | 2014-03-25 |
| Find all providers in zip 07621 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003219536 | Ismile Dental Associates | Dentist | 22 N Washington Ave., Bergenfield, NJ 07621 | 2014-09-29 |
| 1053511121 | Alfonso E Bayuelo | Dentist | 96 S Washington Ave, 2nd Floor, Bergenfield, NJ 07621-2341 | 2007-07-18 |
| 1134295140 | Arien Bahawdory | Dentist | 85 Portland Ave, Bergenfield, NJ 07621-2306 | 2006-11-28 |
| 1104992361 | Jason M Suss | Dentist | 179 S Prospect Ave, Bergenfield, NJ 07621-2640 | 2006-11-28 |
| 1871608430 | David Marc Blass | Dentist | 197 South Washington Ave, Bergenfield, NJ 07621 | 2006-08-21 |
| 1083009203 | Michael Davidson | Dentist | 19 Legion Dr, Bergenfield, NJ 07621-2314 | 2015-04-03 |
| 1437366325 | Richard H Williams | Dentist | 85 Portland Ave, Bergenfield, NJ 07621-2306 | 2007-05-17 |
| 1467674614 | The Dental Way Pa | Dentist | 155 S Washington Ave, Dental Way, Bergenfield, NJ 07621 | 2007-05-03 |
| 1972727345 | Bergenfield Dental Associates | Dentist | 29 W Church St, Bergenfield, NJ 07621-1703 | 2007-04-13 |
| 1134295314 | The Bergenfield Smile Center | Dentist | 179 S Prospect Ave, Bergenfield, NJ 07621-2640 | 2006-11-28 |
| Find all providers in BERGENFIELD | ||||
| City | BERGENFIELD |
| Zip Code | 07621 |
Please comment or provide details below to improve the information on DIVINE DENTAL LLC.
| 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.