Provider Demographics
NPI:1306212303
Name:CENTRAL JERSEY CARING DENTAL
Entity Type:Organization
Organization Name:CENTRAL JERSEY CARING DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:L
Authorized Official - Last Name:SORKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-723-5100
Mailing Address - Street 1:418 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPOTSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08884-1702
Mailing Address - Country:US
Mailing Address - Phone:732-723-5100
Mailing Address - Fax:
Practice Address - Street 1:418 MAIN ST
Practice Address - Street 2:
Practice Address - City:SPOTSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08884-1702
Practice Address - Country:US
Practice Address - Phone:732-723-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CARING DENTAL OF SPOTSWOOD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-13
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01349700261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ401647YXAOMedicare PIN