SOUTH JERSEY PEDIATRIC DENTAL, LLC (NPI# 1598199101) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598199101 |
| Entity Type | Organization |
| Organization Name | SOUTH JERSEY PEDIATRIC DENTAL, LLC |
| Practice Address |
1206 W Sherman Ave Ste 4-d Vineland NJ 08360 |
| Mailing Address |
1206 W Sherman Ave Ste 4-d Vineland NJ 08360-6911 |
| Practice Telephone | 8562134400 |
| Practice Fax Number | 8562134401 |
| Mailing Telephone | 8562134400 |
| Mailing Fax Number | 8562134401 |
| Enumeration Date | 2013-08-30 |
| Last Update Date | 2016-05-19 |
| Authorized Official Name | DR. BRENDALIZ BRISTOL MARTIR (PEDIATRIC DENTIST) |
| Authorized Official Telephone | 8568397019 |
| Authorized Official Credential | D.M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
Dental Providers |
| Street Address |
1206 W SHERMAN AVE STE 4-D |
| City | VINELAND |
| State | NJ |
| Zip Code | 08360 |
| 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 | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467811257 | Dr. Michael B. Rulnick D.m.d. P.c | Dentist | 1450 E Chestnut Ave Ste 6c, Vineland, NJ 08361-8467 | 2016-02-22 |
| 1962654459 | Christine Biondi | Dentist | 301 South Main Road, Maintree Shopping Center Suite B-4, Vineland, NJ 08360 | 2008-10-16 |
| 1801050521 | Karan K Estwick | Dentist | 1103 W Sherman Av, Vineland, NJ 08362 | 2008-07-11 |
| 1922281765 | William R Beck | Dentist | 3071 E Chestnut Ave, Suite D-10, Vineland, NJ 08361-7847 | 2007-12-16 |
| 1104009943 | Pediatric Dentistry of South Jersey, P.C. | Dentist | 3071 E Chestnut Ave, Suite D-10, Vineland, NJ 08361-7847 | 2007-12-16 |
| 1114002177 | Michael Bruce Rulnick | Dentist | 1450 E Chestnut Ave, Suite 6 C, Vineland, NJ 08361-8467 | 2006-10-26 |
| 1427130996 | Stacy Alexis Chin | Dentist | 120 S 6th St, Vineland, NJ 08360-4605 | 2006-10-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508481565 | Kids First Pediatric Dentistry LLC | Dentist | 740 Marne Hwy Ste 103, Moorestown, NJ 08057-3126 | 2020-06-15 |
| 1568008340 | Twinkle Little Star Pediatric Dentistry, LLC | Dentist | 259 Kinderkamack Road, Westwood, NJ 07675 | 2019-11-27 |
| 1558831370 | Amazing Smiles Dentistry for Children, Pa | Dentist | 160 Mountain Ave Ste 101, Hackettstown, NJ 07840-2324 | 2018-12-05 |
| 1063915403 | Singh and Smile Pediatric Dentistry | Dentist | 180 South St Ste 104, New Providence, NJ 07974-1991 | 2018-03-12 |
| 1790285450 | Bright Smiles of Burlington County | Dentist | 693 Main Street, Building B Suite 1, Lumberton, NJ 08048 | 2018-02-19 |
| 1972026144 | Otto M Choi Dds, PC | Dentist | 345 Old Hook Rd, Westwood, NJ 07675-3201 | 2017-07-19 |
| 1386175149 | William Christian Bertram Desonne | Dentist | 1692 Clements Bridge Rd, Deptford, NJ 08096-3028 | 2017-03-23 |
| 1295275758 | Anjali Soni | Dentist | 1910 East Route 70, Ste 9, Cherry Hill, NJ 08003 | 2017-03-03 |
| 1821542176 | Amy R Patel | Dentist | 191 Rte 206 Ste 11, Flanders, NJ 07836-9002 | 2016-08-03 |
| 1891248647 | Lyndhurst Pediatric Dentistry, LLC | Dentist | 710 Ridge Rd, Lyndhurst, NJ 07071-3224 | 2016-07-28 |
| Find all providers with the same taxonomy | ||||
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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.