Provider Demographics
NPI:1548374986
Name:UNIVERSAL DENTAL LLP
Entity type:Organization
Organization Name:UNIVERSAL DENTAL LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST GEN PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIYA
Authorized Official - Middle Name:
Authorized Official - Last Name:DONSKAYA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MSD
Authorized Official - Phone:201-868-6400
Mailing Address - Street 1:6418 BERGENLINE AVE
Mailing Address - Street 2:UNIVERSAL DENTAL LLP
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093
Mailing Address - Country:US
Mailing Address - Phone:201-868-6400
Mailing Address - Fax:201-868-6689
Practice Address - Street 1:6418 BERGENLINE AVE
Practice Address - Street 2:UNIVERSAL DENTAL LLP
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093
Practice Address - Country:US
Practice Address - Phone:201-868-6400
Practice Address - Fax:201-868-6689
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ21295122300000X
NJ2121252122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty