Provider Demographics
NPI:1417725516
Name:SMILES BY BERGEN DENTAL DUMONT LLC
Entity Type:Organization
Organization Name:SMILES BY BERGEN DENTAL DUMONT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LIANY
Authorized Official - Middle Name:
Authorized Official - Last Name:FARINAS-HAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:917-790-9905
Mailing Address - Street 1:310 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EMERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07630-1320
Mailing Address - Country:US
Mailing Address - Phone:917-790-9905
Mailing Address - Fax:
Practice Address - Street 1:166 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:DUMONT
Practice Address - State:NJ
Practice Address - Zip Code:07628-2305
Practice Address - Country:US
Practice Address - Phone:201-384-2112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental