Provider Demographics
NPI:1780675884
Name:SAFFAR, RONALD JASON (DDS)
Entity Type:Individual
Prefix:DR
First Name:RONALD
Middle Name:JASON
Last Name:SAFFAR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:BAHRAM
Other - Middle Name:
Other - Last Name:SAFFAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:59 KILDEE RD
Mailing Address - Street 2:
Mailing Address - City:BELLE MEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08502-5708
Mailing Address - Country:US
Mailing Address - Phone:609-883-3636
Mailing Address - Fax:
Practice Address - Street 1:770 RIVER RD
Practice Address - Street 2:
Practice Address - City:WEST TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08628-3347
Practice Address - Country:US
Practice Address - Phone:609-883-3636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-31
Last Update Date:2014-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI022036001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9043705Medicaid