Provider Demographics
NPI:1780854943
Name:OCEAN FAMILY DENTAL
Entity Type:Organization
Organization Name:OCEAN FAMILY DENTAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DONN
Authorized Official - Middle Name:H
Authorized Official - Last Name:WINOKUR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:732-240-3355
Mailing Address - Street 1:601 RTE 37 W
Mailing Address - Street 2:SUITE 102
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-8050
Mailing Address - Country:US
Mailing Address - Phone:732-240-3355
Mailing Address - Fax:732-240-1121
Practice Address - Street 1:601 RTE 37 W
Practice Address - Street 2:SUITE 102
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-8050
Practice Address - Country:US
Practice Address - Phone:732-240-3355
Practice Address - Fax:732-240-1121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ102021223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ285900901Medicaid