LOUIS J RUSSO JR JONATHAN L NICOZISIS DMD MS PA (NPI# 1942425137) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942425137 |
| Entity Type | Organization |
| Organization Name | LOUIS J RUSSO JR JONATHAN L NICOZISIS DMD MS PA |
| Practice Address |
601 Ewing St B 12 Princeton NJ 08540-2757 |
| Practice Telephone | 6099243271 |
| Mailing Telephone | 6099243271 |
| Enumeration Date | 2007-04-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. JONATHAN LOUIS NICOZISIS (PARTNER, OWNER) |
| Authorized Official Telephone | 6099243271 |
| Authorized Official Credential | DMD MS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
DI 20775 | NJ | Dental Providers |
| Street Address |
601 EWING ST B 12 |
| City | PRINCETON |
| State | NJ |
| Zip Code | 08540-2757 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467455469 | Suzanne B Reinhardt | Dentist | 601 Ewing St, Ste B4, Princeton, NJ 08540-2755 | 2005-05-23 |
| 1518507631 | W.o.w. Counseling & Consulting LLC | Community/Behavioral Health | 601 Ewing St, Princeton, NJ 08540-2757 | 2020-01-07 |
| 1174026694 | Roberta Shakun Devery | Occupational Therapist | 601 Ewing St, Princeton, NJ 08540-2757 | 2018-03-11 |
| 1376075440 | Bhat Psychological Services | Psychologist | 601 Ewing St, Suite A12, Princeton, NJ 08540-2754 | 2017-03-29 |
| 1134589567 | Silver Lining Counseling LLC | Community/Behavioral Health | 601 Ewing St, Suite B5, Princeton, NJ 08540-2757 | 2016-02-26 |
| 1881050896 | Shamila Malik | Social Worker | 601 Ewing St, Suite B5, Princeton, NJ 08540-2757 | 2016-01-06 |
| 1588032320 | Lisa Kestler | Psychologist | 601 Ewing St, Suite C9, Princeton, NJ 08540-2757 | 2015-09-10 |
| 1902281330 | Erin Yurchenko Lpc | Counselor | 601 Ewing St, B5, Princeton, NJ 08540-2757 | 2015-07-28 |
| 1275912461 | Princeton Healthcare Affiliated Physicians PC | Internal Medicine | 601 Ewing St, Ste C13, Princeton, NJ 08540-2758 | 2015-05-21 |
| 1114319696 | Karen Nathan | Nutritionist | 601 Ewing St, C-10, Princeton, NJ 08540-2757 | 2015-02-20 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003420613 | Samantha Beatriz Manzano | Pharmacist | 301 N Harrison Street, Princeton, NJ 08540 | 2020-09-01 |
| 1306485768 | Allies, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 414 Freedom Blvd, Princeton, NJ 08540 | 2020-01-03 |
| 1124667589 | Allies, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 415 Freedom Blvd, Princeton, NJ 08540 | 2020-01-03 |
| 1215576673 | Allies, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 416 Freedom Blvd, Princeton, NJ 08540 | 2020-01-03 |
| 1508405929 | Allies, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 411 Freedom Blvd, Princeton, NJ 08540 | 2020-01-02 |
| 1992369698 | Suzanne Haggerty | Social Worker | 716 Executive Drive, Princeton, NJ 08540 | 2019-04-28 |
| 1700349552 | Pdp Associates LLC | Social Worker | 3490 Us Highway 1, Building 16 Suite 112, Princeton, NJ 08540 | 2019-04-09 |
| 1245722438 | Kyle Bonner | Social Worker | 166 Bunn Dr Ste 105, Princeton, NJ 08540 | 2018-06-04 |
| 1942700125 | Lifetouch Behavioral Health, LLC | Community/Behavioral Health | 112 Commons Way, Building 1, Suite 112, Princeton, NJ 08540 | 2018-02-14 |
| 1912407271 | Princeton Psychiatry & Consulting, LLC | Psychiatry & Neurology | 601 Ewing St, Suite C-10, Princeton, NJ 08540 | 2018-02-13 |
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| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356771687 | Jonathan Louis Nicozisis | Dentist | 601 Ewing St. B-12, Princeton, NJ 08540 | 2013-11-22 |
| 1447362629 | Paul Thomas Castelein | Dentist | 129 North Main Street, Princeton, IL 61356 | 2006-08-31 |
| 1659385243 | Keith A Sabinsky | Dentist | 1 Airport Pl Ste 2, Princeton, NJ 08540-1532 | 2006-07-28 |
| 1841213204 | Sherri M. Salvatore | Dentist | 3495 Us Route 1 South, Princeton, NJ 08540 | 2006-07-26 |
| 1457790784 | Julia Koo | Dentist | 29 Emmons Dr Ste C80, Princeton, NJ 08540-5983 | 2013-06-20 |
| 1609966050 | David Eldredge Fiero | Dentist | 301 N Harrison St, Suite G, Princeton, NJ 08540-3512 | 2006-10-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306452487 | Piskai Orthodontics LLC | Dentist | 302 Haddonfield Berlin Rd, Voorhees, NJ 08043-1413 | 2020-09-23 |
| 1992319537 | Nishat Anbar Shahabuddin | Dentist | 3123 Kennedy Blvd, North Bergen, NJ 07047-2378 | 2020-09-01 |
| 1770192239 | Eastern Dental Holdings, LLC | Dentist | 1030 St. Georges Avenue, Suite 304, Avenel, NJ 07001-1327 | 2020-07-30 |
| 1831714765 | Suzanne Quigley Dmd, LLC | Dentist | 130 Maple Ave Ste 2b, Red Bank, NJ 07701-1729 | 2020-06-16 |
| 1871114512 | Marigold Pediatric Dentistry and Orthodontics | Dentist | 1713 Springfield Ave, Maplewood, NJ 07040-2914 | 2020-05-05 |
| 1366076648 | Robert Vartkis Kinoian | Dentist | 138 Spring Valley Rd, Paramus, NJ 07652-5332 | 2020-02-26 |
| 1932732856 | Elite Orthodontics | Dentist | 61 Berdan Ave, Wayne, NJ 07470-3231 | 2020-02-19 |
| 1568006583 | Bowen Family Orthodontics, LLC | Dentist | 7 Myers Dr Ste B, Mullica Hill, NJ 08062-9513 | 2019-11-01 |
| 1376185181 | Robert Bray | Dentist | 620 Shore Road, Somers Point, NJ 08244 | 2019-10-14 |
| 1295376010 | Amy H Hoch | Dentist | 105 Reids Hill Rd Ste A, Matawan, NJ 07747-4003 | 2019-10-02 |
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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.