Provider Demographics
NPI:1750377933
Name:KATZ, STUART ALAN (DMD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:ALAN
Last Name:KATZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BROADWAY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07407-1842
Mailing Address - Country:US
Mailing Address - Phone:201-794-3344
Mailing Address - Fax:201-794-0454
Practice Address - Street 1:1 BROADWAY
Practice Address - Street 2:SUITE 101
Practice Address - City:ELMWOOD PARK
Practice Address - State:NJ
Practice Address - Zip Code:07407-1842
Practice Address - Country:US
Practice Address - Phone:201-794-3344
Practice Address - Fax:201-794-0454
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI015847001223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJD04924401OtherCDS NUMBER
NJ22DI01584700OtherNJ DENTAL LICENSE
NJ418OtherGA PERNIT NUMBER
NJ3702OtherNJ SPECIALTY NUMBER
NJ3702OtherNJ SPECIALTY NUMBER
NJD04924401OtherCDS NUMBER
NJD04924401OtherCDS NUMBER