Provider Demographics
NPI:1003900861
Name:ESSEX DENTAL P.C.
Entity Type:Organization
Organization Name:ESSEX DENTAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-403-3455
Mailing Address - Street 1:155 ROSELAND AVE.
Mailing Address - Street 2:STE. 6
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-5903
Mailing Address - Country:US
Mailing Address - Phone:973-403-3455
Mailing Address - Fax:973-403-7804
Practice Address - Street 1:155 ROSELAND AVE.
Practice Address - Street 2:STE. 6
Practice Address - City:CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-5903
Practice Address - Country:US
Practice Address - Phone:973-403-3455
Practice Address - Fax:973-403-7804
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1021651001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty