Provider Demographics
NPI:1942819644
Name:IRIE DENTAL SPA OF THE ORANGES
Entity Type:Organization
Organization Name:IRIE DENTAL SPA OF THE ORANGES
Other - Org Name:IRIE DENTAL SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RUTH
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:PARKIN-EDWIN
Authorized Official - Suffix:
Authorized Official - Credentials:DENTIST
Authorized Official - Phone:973-673-4743
Mailing Address - Street 1:15 FREEMAN AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-3429
Mailing Address - Country:US
Mailing Address - Phone:973-673-4743
Mailing Address - Fax:973-453-8146
Practice Address - Street 1:15 FREEMAN AVE
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07018-3429
Practice Address - Country:US
Practice Address - Phone:973-673-4743
Practice Address - Fax:973-453-8146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-28
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty