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

Willowbrook Mall Dental, PA

Organization General Practice Dentistry · NPI 1174685713

Willowbrook Mall Dental, PA is a General Practice Dentistry in Wayne, New Jersey. Licensed in New Jersey. Registered with an NPI since 2006.

Licensed in
NJ
In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1445 Willowbrook Blvd
Wayne, NJ 07470
Phone: (973) 812-4426
Fax: (973) 812-4405
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 19779 (NJ)

Record details

NPI number1174685713
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Alexander Mikhailov — Owner · (973) 812-4266
NPI enumeratedDecember 13, 2006
Last updated in NPPESAugust 22, 2020
Mailing address1445 Willowbrook Blvd, Wayne, NJ 07470

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