Provider Demographics
NPI:1295567840
Name:BERGEN TMJ
Entity type:Organization
Organization Name:BERGEN TMJ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS, FAAOP
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:KABARIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-745-6922
Mailing Address - Street 1:559 WESTBROOK CT
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652-1821
Mailing Address - Country:US
Mailing Address - Phone:201-745-6922
Mailing Address - Fax:
Practice Address - Street 1:140 NJ-17 N #314
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652
Practice Address - Country:US
Practice Address - Phone:201-292-4552
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X2210XDental ProvidersDentistOrofacial PainGroup - Single Specialty