Provider Demographics
NPI:1134143795
Name:SCHILLING, JOEL BARRY (DDS)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:BARRY
Last Name:SCHILLING
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 1:21 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:PARK RIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07656-1231
Mailing Address - Country:US
Mailing Address - Phone:201-391-5944
Mailing Address - Fax:201-476-9894
Practice Address - Street 1:21 PARK AVE
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:NJ
Practice Address - Zip Code:07656-1231
Practice Address - Country:US
Practice Address - Phone:201-391-5944
Practice Address - Fax:201-476-9894
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ101911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice