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.
Organization
PREMIER ORAL SURGERY OF BERGEN COUNTY PC
Active
Organization
PREMIER ORAL SURGERY OF BERGEN COUNTY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN KALLIS DMD (OWNER)
(201) 385-0775
Entity
Organization
Contact information
Practice address
375 S WASHINGTON AVE, BERGENFIELD, NJ 07621-4323
(201) 385-0775
(201) 385-5375
Mailing address
375 S WASHINGTON AVE, BERGENFIELD, NJ 07621-4323
(201) 385-0775
(201) 385-5375
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DI15472
STATE DENTAL LICENSE
NJ
Enumeration date
09/19/2019
Last updated
09/19/2019
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up