Provider Demographics
NPI:1639265697
Name:KITAY, DENISE (DDS MMSC)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:
Last Name:KITAY
Suffix:
Gender:F
Credentials:DDS MMSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 BLOOMFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006
Mailing Address - Country:US
Mailing Address - Phone:973-228-3366
Mailing Address - Fax:973-228-9607
Practice Address - Street 1:199 BALDWIN ROAD
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054
Practice Address - Country:US
Practice Address - Phone:973-334-4223
Practice Address - Fax:973-334-3177
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ188011223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics