Provider Demographics
NPI:1114215027
Name:ROONEY, BRIAN JOSEPH (DDS)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:JOSEPH
Last Name:ROONEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2291 ROUTE 33 STE 1002
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08690-1717
Mailing Address - Country:US
Mailing Address - Phone:609-588-5601
Mailing Address - Fax:609-588-5602
Practice Address - Street 1:2291 ROUTE 33 STE 1002
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08690
Practice Address - Country:US
Practice Address - Phone:609-588-5601
Practice Address - Fax:609-588-5602
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-12
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA604131223P0221X
PADS0398491223P0221X, 1223P0221X
NJ22DI025725001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry