Provider Demographics
NPI:1477048908
Name:ISAACS, ANNE (DDS)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:
Last Name:ISAACS
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 MOUNTAIN BLVD
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5608
Mailing Address - Country:US
Mailing Address - Phone:908-381-0192
Mailing Address - Fax:
Practice Address - Street 1:28 MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5608
Practice Address - Country:US
Practice Address - Phone:908-381-0192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD165741223P0221X
390200000X
NJ22DI029677001223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program