Provider Demographics
NPI:1558586685
Name:NEJAT, DANIEL BENJAMIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:BENJAMIN
Last Name:NEJAT
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 SPARTA RD
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-1330
Mailing Address - Country:US
Mailing Address - Phone:973-379-7635
Mailing Address - Fax:
Practice Address - Street 1:349 E NORTHFIELD RD
Practice Address - Street 2:SUITE 207
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-4802
Practice Address - Country:US
Practice Address - Phone:973-535-4300
Practice Address - Fax:973-535-4308
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022280001223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics