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Organization
JERSEY SMILES
Active
Organization
JERSEY SMILES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHANKAR IYER DDS MDS (PRESIDENT)
(201) 659-7717
Entity
Organization
Contact information
Practice address
3000 KENNEDY BLVD, JERSEY CITY, NJ 07306-3817
(201) 659-7717
(201) 659-9633
Mailing address
3000 KENNEDY BLVD, JERSEY CITY, NJ 07306-3817
(201) 659-7717
(201) 659-9633
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
NULL
1223G0001X
General Practice Dentistry
—
—
1223P0700X
Prosthodontics
Primary
—
NULL
1223P0700X
Prosthodontics
Primary
—
—
124Q00000X
Dental Hygienist
—
NULL
124Q00000X
Dental Hygienist
—
—
Other
Enumeration date
10/21/2008
Last updated
10/21/2008
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