SOUTH JERSEY DENTAL STUDIO LLC – NPI #1053035576
Clinic/Center

SOUTH JERSEY DENTAL STUDIO LLC is an AHC clinic located in CHERRY HILL, NJ. NPPES has assigned the NPI number 1053035576 to SOUTH JERSEY DENTAL STUDIO LLC on September 28, 2022. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 261QD0000X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Dental

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 SOUTH JERSEY DENTAL STUDIO LLC below.

NPI Profile for
SOUTH JERSEY DENTAL STUDIO LLC

NPI Number
1053035576
Enumeration Date

(more than 3 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
SOUTH JERSEY DENTAL STUDIO LLC
Primary location
539 MARLTON PIKE W
CHERRY HILL, NJ 08002
Phone: (856) 406-6570 Fax:
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
DARA NIKOONEZHAD
OWNER/DENTIST
Phone: (732) 615-8087
Updated
Certification Date
Sep 27, 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
261QD0000X
- Clinic/Center / Dental (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.