Provider Demographics
NPI:1497225536
Name:OHANA DENTAL LLC
Entity Type:Organization
Organization Name:OHANA DENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:VENUTI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:516-581-9249
Mailing Address - Street 1:30 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07432-1635
Mailing Address - Country:US
Mailing Address - Phone:201-444-5675
Mailing Address - Fax:
Practice Address - Street 1:30 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:MIDLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:07432-1635
Practice Address - Country:US
Practice Address - Phone:201-444-5675
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-02
Last Update Date:2018-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental