Provider Demographics
NPI:1598923187
Name:EASTERN DENTAL OF PARSIPPANY, LLC
Entity Type:Organization
Organization Name:EASTERN DENTAL OF PARSIPPANY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DENTAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:FEILER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:973-292-2550
Mailing Address - Street 1:2936 ROUTE 10 WEST
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07950-1244
Mailing Address - Country:US
Mailing Address - Phone:973-292-2550
Mailing Address - Fax:
Practice Address - Street 1:2936 ROUTE 10 WEST
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07950-1244
Practice Address - Country:US
Practice Address - Phone:973-292-2550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ205091223G0001X
NJ109671223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty