Provider Demographics
NPI:1326137449
Name:ROZENBLIT, IRINA (DDS)
Entity Type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:ROZENBLIT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 COBBLEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-2037
Mailing Address - Country:US
Mailing Address - Phone:973-740-9187
Mailing Address - Fax:973-740-0935
Practice Address - Street 1:35 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08835-1801
Practice Address - Country:US
Practice Address - Phone:908-725-0900
Practice Address - Fax:908-725-0907
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI020185001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice