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Contact Information

DIVINE DENTAL LLC
485 S WASHINGTON AVE
BERGENFIELD, NJ07621-4313
 Phone: 201-345-8881
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
 

Customized Equipment

332BC3200X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for DIVINE DENTAL LLC

NPI Number 1336772664
LBN Legal business name DIVINE DENTAL LLC
Authorized official JAMES KANG - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/14/2020
Last updated 02/14/2020 - About 6 years ago
Identifiers n/a
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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