Provider Demographics
NPI:1215013339
Name:AMATO, CYRUS J (DDS)
Entity Type:Individual
Prefix:DR
First Name:CYRUS
Middle Name:J
Last Name:AMATO
Suffix:
Gender:M
Credentials:DDS
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Mailing Address - Street 1:101 OLD SHORT HILLS ROAD
Mailing Address - Street 2:PENTHOUSE II
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052
Mailing Address - Country:US
Mailing Address - Phone:973-736-7616
Mailing Address - Fax:973-325-3487
Practice Address - Street 1:101 OLD SHORT HILLS ROAD
Practice Address - Street 2:PENTHOUSE II
Practice Address - City:WEST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07052
Practice Address - Country:US
Practice Address - Phone:973-736-7616
Practice Address - Fax:973-325-3487
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ22DI007831001223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ520601Medicare PIN