JERSEY SHORE DENTAL SPA LLC (NPI# 1649745589) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649745589 |
| Entity Type | Organization |
| Organization Name | JERSEY SHORE DENTAL SPA LLC |
| Practice Address |
613 Hope Road Building 5 Eatontown NJ 07724 |
| Mailing Address |
604 Main St Apt 2 Belmar NJ 07719-5141 |
| Practice Telephone | 7327701239 |
| Mailing Telephone | 7327701239 |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2018-10-08 |
| Authorized Official Name | DR. MARC AARON CHRISTY (OWNER DENTIST) |
| Authorized Official Telephone | 7327701239 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Street Address |
613 HOPE ROAD BUILDING 5 |
| City | EATONTOWN |
| State | NJ |
| Zip Code | 07724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437719788 | Zsanae Lewis | Driver | 1 Main St Unit 401, Eatontown, NJ 07724 | 2019-06-18 |
| 1417419169 | Refocus | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 613 Hope Road, Building 5 and 2, Eatontown, NJ 07724 | 2019-04-02 |
| 1215401575 | Angela Fordham-lewis | Day Training/Habilitation Specialist | 613 Hope Road, Building #2, Eatontown, NJ 07724 | 2019-01-18 |
| 1174094312 | Patti Kousoulis | Counselor | 10 Industrial Way East, Eatontown, NJ 07724 | 2018-12-16 |
| 1487135448 | A2z Diagnostics LLC | Pathology | 6 Industrial Way W Ste F19, Eatontown, NJ 07724 | 2018-08-27 |
| 1942708268 | Elyce Jackson | Counselor | 10 Industrial Way, Eatontown, NJ 07724 | 2018-02-01 |
| 1477065894 | The Arc of Monmouth, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 36 Country Club Road Apt. 249, Eatontown, NJ 07724 | 2017-10-25 |
| 1639681059 | The Arc of Monmouth, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 36 Country Club Road Apt. 277, Eatontown, NJ 07724 | 2017-10-25 |
| 1669998100 | Seacrest Recovery Center North Jersey, LLC | Psychologist | 162 Highway 35, Eatontown, NJ 07724 | 2017-08-16 |
| 1265956221 | The Arc of Monmouth, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 36 Country Club Road, Country Club Estates Apt 81, Eatontown, NJ 07724 | 2017-08-01 |
| Find all providers in zip 07724 | ||||
| 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 |
|---|---|---|---|---|
| 1609189711 | Nisha Chandravadan Patel | Dentist | 37 Hwy 35, Eatontown, NJ 07724-3900 | 2010-07-17 |
| 1710290176 | Nadya Aldochine | Dentist | 288 Highway 35 S, Eatontown, NJ 07724-2174 | 2010-07-14 |
| 1588827596 | Abiola A. Sadiq | Dentist | 37 Highway 35 Ste 6, Eatontown, NJ 07724-3493 | 2008-07-09 |
| 1376768176 | Donald Frederick | Dentist | 288 State Route 35 S, Eatontown, NJ 07724-2105 | 2007-04-16 |
| 1407920325 | Anthony M. Villane Jr. | Dentist | 15 White St, Eatontown, NJ 07724-1524 | 2006-11-20 |
| 1437591567 | Monmouth Mall Dental, Pa | Dentist | 180 Route 35 S, Eatontown, NJ 07724-2023 | 2013-07-17 |
| 1629285002 | Ogonna Oge Orjiekwe | Dentist | 37 Highway 35, Eatontown, NJ 07724 | 2007-05-16 |
| 1720291917 | Elena Agilina | Dentist | 288 State Route 35 S, Eatontown, NJ 07724-2105 | 2007-05-07 |
| 1790906584 | Comp Care 2000, LLC | Dentist | 288 State Route 35 S, Eatontown, NJ 07724-2105 | 2007-05-01 |
| 1356562151 | Rupal Bordia | Dentist | 288 State Route 35 S, Eatontown, NJ 07724-2105 | 2007-05-01 |
| Find all providers in EATONTOWN | ||||
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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.