RUTGERS HEALTH -UNIVERSITY DENTAL ASSOCIATES (NPI# 1346454584) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346454584 |
| Entity Type | Organization |
| Organization Name | RUTGERS HEALTH -UNIVERSITY DENTAL ASSOCIATES |
| Other Organization Name | RUTGERS HEALTH GROUP |
| Practice Address |
90 Bergen St Suite 7700 Newark NJ 07103-2425 |
| Practice Telephone | 9739722444 |
| Practice Fax Number | 9739722441 |
| Mailing Telephone | 9739728668 |
| Mailing Fax Number | 9739722441 |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2017-07-14 |
| Authorized Official Name | DR. VICENTE H GRACIAS (PRESIDENT) |
| Authorized Official Telephone | 7322357631 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers | ||
| N | 1223P0300X |
Dentist Specialization: Periodontics |
Dental Providers | ||
| N | 1223P0700X |
Dentist Specialization: Prosthodontics |
Dental Providers | ||
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
Dental Providers | ||
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
22DI01997900 | NJ | Dental Providers |
| N | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
Dental Providers | ||
| N | 124Q00000X | Dental Hygienist | Dental Providers | ||
| N | 126800000X | Dental Assistant | Dental Providers | ||
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 250009 | 05 |
| Other Name | Type Code |
|---|---|
| Rutgers Health Group | Other Name - Individual/Organization |
| Street Address |
90 BERGEN ST SUITE 7700 |
| City | NEWARK |
| State | NJ |
| Zip Code | 07103-2425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285623074 | Karen Virginia Valdez-gonzalez | Genetic Counselor, MS | 90 Bergen St, Doctors Office Center - Suite 5400, Newark, NJ 07103-2425 | 2005-10-14 |
| 1134758816 | Elizabeth Elaine Ginalis | Student in an Organized Health Care Education/Training Program | 90 Bergen St, Newark, NJ 07103-2425 | 2020-04-05 |
| 1003462854 | University Surgical Associates (om) | Transplant Surgery | 90 Bergen St, Newark, NJ 07103-2425 | 2019-08-16 |
| 1528614021 | Special LLC | Plastic Surgery | 90 Bergen St, Newark, NJ 07103-2425 | 2019-08-12 |
| 1265993216 | Sean Michael Munier | Student in an Organized Health Care Education/Training Program | 90 Bergen St, Newark, NJ 07103-2425 | 2019-03-30 |
| 1629539861 | Ali Tayebi Meybodi | Student in an Organized Health Care Education/Training Program | 90 Bergen St, Newark, NJ 07103-2425 | 2019-03-29 |
| 1497214282 | Brandon Khoa Nguyen | Student in an Organized Health Care Education/Training Program | 90 Bergen St, Newark, NJ 07103-2425 | 2019-03-19 |
| 1649776790 | Purvee D Patel | Student in an Organized Health Care Education/Training Program | 90 Bergen St, Newark, NJ 07103-2425 | 2018-04-05 |
| 1740716703 | Elena Solli | Student in an Organized Health Care Education/Training Program | 90 Bergen St, Doctor's Office Center, Neurological Surgery Dept., Newark, NJ 07103-2425 | 2017-05-11 |
| 1881120954 | Ivo Bach | Student in an Organized Health Care Education/Training Program | 90 Bergen St, Suite 5200, Newark, NJ 07103-2425 | 2017-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124657077 | Yingna Liu | Student in an Organized Health Care Education/Training Program | Medical Science Building, 185 South Orange Avenue, Newark, NJ 07103 | 2020-04-03 |
| 1568029684 | Martins Akhibi | Nurse Practitioner | 178 Newton Street, Newark, NJ 07103 | 2019-05-23 |
| 1972168482 | Newark Renaissance House, Inc | Rehabilitation, Substance Use Disorder Unit | 50-56 Norfolk Street, Newark, NJ 07103 | 2019-05-09 |
| 1346709235 | Ian Wang Yu | Student in an Organized Health Care Education/Training Program | 185 South Orange Ave., Medical Science Building, Room I-506, Newark, NJ 07103 | 2019-03-19 |
| 1437648417 | Stephen Vanbeek | Internal Medicine | 185 S Orange Ave Rm 547, Newark, NJ 07103 | 2018-05-06 |
| 1073019444 | Geoffrey Alexander Talis | Student in an Organized Health Care Education/Training Program | 183 S. Orange Avenue, Level E, Room 1452, Newark, NJ 07103 | 2018-04-03 |
| 1285139907 | Thomas Georg Bachmann | Student in an Organized Health Care Education/Training Program | 185 South Orange Ave, Medical Science Building, G-538, Newark, NJ 07103 | 2018-03-26 |
| 1154825289 | Shammi A Patel | Student in an Organized Health Care Education/Training Program | 185 S Orange Ave # Msbg594, Newark, NJ 07103 | 2018-03-22 |
| 1982122545 | North Jersey Aids Alliance | Clinic/Center | 393 Central Avenue C/o Corey Destefano, Newark, NJ 07103 | 2017-09-05 |
| 1134655533 | Yasmin N Abedin | Student in an Organized Health Care Education/Training Program | 185 South Orange Ave, Msb E-506, Rutgers, New Jersey Medical School, Newark, NJ 07103 | 2017-05-04 |
| Find all providers in zip 07103 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184099251 | Child Smiles Spec LLC | Dentist | 67-73 Fillmore Street, Newark, NJ 07105 | 2015-12-01 |
| 1235395971 | Dara Siegel | Dentist | 110 Bergen St Ste 883a, Newark, NJ 07103 | 2008-08-01 |
| 1245303387 | Omega Endodontics, LLC | Dentist | 31 Omega Dr, Suite J-31, Newark, DE 19713-2058 | 2006-11-16 |
| 1003425562 | A&c Dental Concepts LLC | Dentist | 233 Lafayette St, Newark, NJ 07105-1813 | 2020-07-29 |
| 1306479902 | Childsmiles PC Holdings Nj Pa | Dentist | 45 Bleeker St, Newark, NJ 07102-1913 | 2020-02-21 |
| 1275054066 | Sara E Soumeeh | Dentist | 66 Somme St, Newark, NJ 07105-3612 | 2017-06-30 |
| 1013468040 | Infinite Endodontics 2 | Dentist | 66 Somme St, Newark, NJ 07105-3612 | 2016-10-14 |
| 1073061297 | Marianella Natera-fernandez | Dentist | 110 Bergen St, D883, Newark, NJ 07103-2495 | 2016-09-16 |
| 1144612250 | Carla Yvonne Falcon | Dentist | 110 Bergen St, Newark, NJ 07103-2495 | 2015-02-26 |
| 1750794996 | Samin F Nawaz | Dentist | 110 Bergen St, Room C-790, Newark, NJ 07103-2495 | 2014-06-05 |
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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.