Provider Demographics
NPI:1588614853
Name:ADULTS AND KIDS DENTAL CARE
Entity Type:Organization
Organization Name:ADULTS AND KIDS DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PING
Authorized Official - Middle Name:
Authorized Official - Last Name:CAI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-264-8001
Mailing Address - Street 1:40 VILLAGE CT
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1534
Mailing Address - Country:US
Mailing Address - Phone:732-264-8001
Mailing Address - Fax:732-264-7835
Practice Address - Street 1:40 VILLAGE CT
Practice Address - Street 2:
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1534
Practice Address - Country:US
Practice Address - Phone:732-264-8001
Practice Address - Fax:732-264-7835
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI021906001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0056456Medicaid