Provider Demographics
NPI:1144609454
Name:CHARMING SMILE CORP
Entity Type:Organization
Organization Name:CHARMING SMILE CORP
Other - Org Name:CHARMING SMILE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MEETU
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGAL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:201-425-8600
Mailing Address - Street 1:1 PARKVIEW DR
Mailing Address - Street 2:
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1501
Mailing Address - Country:US
Mailing Address - Phone:551-358-4728
Mailing Address - Fax:
Practice Address - Street 1:115 CHRISTOPHER COLUMBUS DR
Practice Address - Street 2:SUITE 200
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-5526
Practice Address - Country:US
Practice Address - Phone:201-425-8600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-20
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02421900122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0244660Medicaid