Provider Demographics
NPI:1508012147
Name:BARBARA A FODERO, DDS, MS
Entity Type:Organization
Organization Name:BARBARA A FODERO, DDS, MS
Other - Org Name:CHATHAM ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:A
Authorized Official - Last Name:FODERO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:973-701-2200
Mailing Address - Street 1:33 MAIN ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-2433
Mailing Address - Country:US
Mailing Address - Phone:973-701-2200
Mailing Address - Fax:973-701-2210
Practice Address - Street 1:33 MAIN ST
Practice Address - Street 2:SUITE 104
Practice Address - City:CHATHAM
Practice Address - State:NJ
Practice Address - Zip Code:07928-2433
Practice Address - Country:US
Practice Address - Phone:973-701-2200
Practice Address - Fax:973-701-2210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-14
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI0211241223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1558483768OtherINDIVIDUAL NPI