CHILDREN'S DENTAL SURGERY OF JACKSON – NPI #1710552278
Clinic/Center

CHILDREN'S DENTAL SURGERY OF JACKSON is an AHC clinic located in JACKSON, NJ. NPPES has assigned the NPI number 1710552278 to CHILDREN'S DENTAL SURGERY OF JACKSON on May 26, 2021. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “CHILDREN'S DENTAL SURGERY OF JACKSON” is a dba name, the actual legal business name for this organization is CHILDREN'S DENTAL SURGERY CENTER OF JACKSON LLC. The primary taxonomy selected by this provider is 261QA1903X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Ambulatory Surgical

The NPI profile was previously updated about 4 years ago on Aug 24, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CHILDREN'S DENTAL SURGERY OF JACKSON below.

NPI Profile for
CHILDREN'S DENTAL SURGERY CENTER OF JACKSON LLC

NPI Number
1710552278
Enumeration Date

(more than 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CHILDREN'S DENTAL SURGERY CENTER OF JACKSON LLC
Doing Business As (dba): CHILDREN'S DENTAL SURGERY OF JACKSON
Primary location
27 S COOKS BRIDGE RD STE 2-3
JACKSON, NJ 08527-2462
Phone: (732) 928-1099 Fax: (732) 833-1690
Mailing address
300 WILLOWBROOK LN STE 330
WEST CHESTER, PA 19382-5594
Phone: (267) 575-2321 Fax:
Organization Subpart
No
Authorized Official
VAN PHI LE
CREDENTIALING CONTRACTS MANAGER
Phone: (267) 575-2321
Updated
Certification Date
Aug 24, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QA1903X
- Clinic/Center / Ambulatory Surgical (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.