Provider Demographics
NPI:1730220534
Name:DR. MITCHELL A. KAGAN DDS & DR. JEFFREY C. BOGDEN DMD
Entity type:Organization
Organization Name:DR. MITCHELL A. KAGAN DDS & DR. JEFFREY C. BOGDEN DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MITCHELL
Authorized Official - Middle Name:A
Authorized Official - Last Name:KAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:908-753-1772
Mailing Address - Street 1:176 CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:NORTH PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-3941
Mailing Address - Country:US
Mailing Address - Phone:908-753-1772
Mailing Address - Fax:908-755-2211
Practice Address - Street 1:176 CEDAR ST
Practice Address - Street 2:
Practice Address - City:NORTH PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-3941
Practice Address - Country:US
Practice Address - Phone:908-753-1772
Practice Address - Fax:908-755-2211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ123941223G0001X
NJ114481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty