SURFSIDE SMILE COMPANY LLC – NPI #1679280630
Clinic/Center

SURFSIDE SMILE COMPANY LLC is an AHC clinic located in MIDDLETOWN, NJ. NPPES has assigned the NPI number 1679280630 to SURFSIDE SMILE COMPANY LLC on October 31, 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

The NPI profile was previously updated about 3 years ago on Jan 28, 2023. 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 SURFSIDE SMILE COMPANY LLC below.

NPI Profile for
SURFSIDE SMILE COMPANY LLC

NPI Number
1679280630
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
SURFSIDE SMILE COMPANY LLC
Primary location
1692 HIGHWAY 35
MIDDLETOWN, NJ 07748
Phone: (757) 214-1091 Fax:
Mailing address
2404 CHERRY ST
MANASQUAN, NJ 08736-1523
Phone: Fax:
Organization Subpart
No
Authorized Official
KRISTIANNE MACARAEG KRACKE
OWNER
Phone: (757) 214-1091
Updated
Certification Date
Jan 28, 2023

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.