# NORTH BERGEN FAMILY DENTAL CARE LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225197361
- **Authorized official:** DR. MANORAMA GUNTUNUR DDS (GENERAL DENTIST)
- **Authorized official phone:** (201) 869-0030

## Contact information

- **Practice address:** 7821 BERGENLINE AVE, NORTH BERGEN, NJ 07047-4942
- **Practice address phone:** (201) 869-0030
- **Practice address fax:** (201) 869-0020
- **Mailing address:** 7821 BERGENLINE AVE, NORTH BERGEN, NJ 07047-4942
- **Mailing address phone:** (201) 869-0030
- **Mailing address fax:** (201) 869-0020

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DI20520 | NJ | Yes |

## Other

- **Enumeration date:** 12/06/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 016386 | AMERIGROUP | NJ |
| 01 | — | 1086983 | HORIZON HEALTH CARE | — |
| 01 | — | 20520 | DELTA | NJ |
| 01 | — | 223354 | CIGNA | — |
| 01 | — | 30536 | AETNA | NJ |
| 05 | — | 7794509 | — | NJ |
| 01 | — | 985772 | UNITED CONCORDIA | — |