# SENIOR CARE DENTAL

> 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:** 1356413777
- **Authorized official:** MS. ANNETTE SANTIAGO (SUPERVISOR BILLER)
- **Authorized official phone:** (973) 446-0620

## Contact information

- **Practice address:** 345 PASSAIC AVE, 1ST FL, LODI, NJ 07644
- **Practice address phone:** (973) 446-0620
- **Practice address fax:** (973) 446-0620
- **Mailing address:** 93 HOME PLACE, 1ST FL, LODI, NJ 07644
- **Mailing address phone:** (973) 446-0620
- **Mailing address fax:** (973) 446-0620

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 11/14/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0014931 | — | NJ |