Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

201 Oral Surgery

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1073896809

201 Oral Surgery is an Oral and Maxillofacial Surgery (Dentist) in Old Tappan, New Jersey. Licensed in New Jersey. Registered with an NPI since 2011.

Licensed in
NJ
In the registry since
2011
Specialties on file
3

Practice location Address checks out

180 Old Tappan Rd
Old Tappan, NJ 07675-7052
Phone: (201) 767-4001
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X · Licence 22DI02332400 (NJ)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence 22DI01547211 (NJ)
Oral and Maxillofacial Surgery (Dentist) Taxonomy 1223S0112X · Licence 22DI01805400 (NJ)

Record details

NPI number1073896809
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Suzanne Waltke — Office Manager · (201) 767-4001
NPI enumeratedSeptember 28, 2011
Last updated in NPPESSeptember 28, 2011
Mailing address180 Old Tappan Rd, Old Tappan, NJ 07675-7052

Other providers in Old Tappan