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Export Provider Record NPI 1033236625
Eastern Dental Of Vineland, Llc
Organization Subpart: NO
Active
NPI Number1033236625
NPI TypeNPI-2 Organization
SpecialtyDentist, Orthodontics and Dentofacial Orthopedics
Provider Details
NPI1033236625
NPI TypeNPI-2 Organization
StatusActive
Enumeration Date2007-03-26
Last Updated2025-09-11
Authorized OfficialMichael Bundy
Director
Phone: 8566925400
Mailing Address1030 Saint Georges Ave
Avenel, NJ 07001-1390
United States
📍 View Map
Primary Practice Address1145 E Chestnut Ave
Vineland, NJ 08360-5001
United States
Phone: (856) 692-5400
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No1223G0001X – Dentist, General PracticeNJ22761
No1223P0300X – Dentist, PeriodonticsNJ09460
No1223S0112X – Dentist, Oral and Maxillofacial SurgeryNJ07879
Yes1223X0400X – Dentist, Orthodontics and Dentofacial OrthopedicsNJ23068
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About NPI 1033236625

Eastern Dental Of Vineland, Llc is an organization registered in the CMS NPPES NPI Registry with NPI number 1033236625. The primary specialty listed is Dentist, Orthodontics and Dentofacial Orthopedics. The organization is located in Vineland, NJ. This NPI is classified as a Type 2 (Organizational) NPI and is currently active. The NPI was first enumerated (assigned) on 2007-03-26. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1033236625?

NPI 1033236625 belongs to Eastern Dental Of Vineland, Llc, a Dentist, Orthodontics and Dentofacial Orthopedics in Vineland, NJ. It is a Type 2 Organizational NPI registered in the CMS NPPES NPI Registry.

Is NPI 1033236625 active?

The current status of NPI 1033236625 in the NPPES registry is Active. The record was last updated on 2025-09-11.

What specialty is NPI 1033236625?

NPI 1033236625 is classified under the taxonomy Dentist, Orthodontics and Dentofacial Orthopedics. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1033236625?

You can verify NPI 1033236625 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1033236625?

The primary practice address on file for NPI 1033236625 is 1145 E Chestnut Ave, Vineland, NJ 08360-5001. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1033236625 issued?

NPI 1033236625 was first issued (enumerated) on 2007-03-26. The NPPES record was last updated on 2025-09-11.

Practice Location Map

Eastern Dental Of Vineland, Llc is located at 1145 E Chestnut Ave, Vineland, NJ. Use the map below to find directions or verify the practice location.

📍 1145 E Chestnut Ave, Vineland, NJ 08360-5001  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Eastern Dental Of Vineland, Llc. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1033236625. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Dentist, General Practice22761NJ
Dentist, Periodontics09460NJ
Dentist, Oral and Maxillofacial Surgery07879NJ
Dentist, Orthodontics and Dentofacial Orthopedics23068NJ
Data Verified from CMS NPPES Last synced: 2026-07-25 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162