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Contact Information

21ST AVE DENTAL LLC
318 21ST AVE
PATERSON, NJ07501-3538
 Phone: 973-742-1991
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for 21ST AVE DENTAL LLC

NPI # 1114203387
LBN Legal business name 21ST AVE DENTAL LLC
Authorized official PATRICK RYAN - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 11/01/2011
Last updated 11/01/2011 - About 15 years ago
Identifiers
NJ License # 14409
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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