Provider Demographics
NPI:1609552009
Name:WHITE OAK DENTAL NJ LLC
Entity Type:Organization
Organization Name:WHITE OAK DENTAL NJ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AQUINO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:732-582-4224
Mailing Address - Street 1:1040 US HIGHWAY 1 STE 103
Mailing Address - Street 2:
Mailing Address - City:AVENEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07001-1539
Mailing Address - Country:US
Mailing Address - Phone:732-582-4224
Mailing Address - Fax:732-582-4211
Practice Address - Street 1:1040 US HIGHWAY 1 STE 103
Practice Address - Street 2:
Practice Address - City:AVENEL
Practice Address - State:NJ
Practice Address - Zip Code:07001-1539
Practice Address - Country:US
Practice Address - Phone:732-582-4224
Practice Address - Fax:732-582-4211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty