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

Surgery Center of Penthouse IV

Organization Oral and Maxillofacial Surgery (Dentist) · NPI 1710060496

Surgery Center of Penthouse IV is an Oral and Maxillofacial Surgery (Dentist) in West Orange, New Jersey. Registered with an NPI since 2006.

In the registry since
2006

Practice location Address checks out

101 Old Short Hills Rd
West Orange, NJ 07052
Phone: (973) 736-1345
Fax: (973) 325-3487
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery (Dentist) (primary) Taxonomy 1223S0112X

Record details

NPI number1710060496
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Theodore Niebloom — Doctor Administrative Director · (973) 736-7616
NPI enumeratedOctober 24, 2006
Last updated in NPPESAugust 22, 2020
Mailing address101 Old Short Hills Road, West Orange, NJ 07052

Other providers in West Orange