Provider Demographics
NPI:1821290156
Name:DREW LOMBARDI, DMD & SUSAN RIDER, DDS, MSD
Entity Type:Organization
Organization Name:DREW LOMBARDI, DMD & SUSAN RIDER, DDS, MSD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER, ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DREW
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:LOMBARDI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-224-3600
Mailing Address - Street 1:810 ABBOTT BLVD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-4151
Mailing Address - Country:US
Mailing Address - Phone:201-224-3600
Mailing Address - Fax:201-886-3443
Practice Address - Street 1:810 ABBOTT BLVD
Practice Address - Street 2:SUITE 301
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-4151
Practice Address - Country:US
Practice Address - Phone:201-224-3600
Practice Address - Fax:201-886-3443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI013567001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty