Search › New Jersey › 1223P0221X
Jimmy Shak
NPI 1285132530 · on the registry since 2018 · sole proprietor
Practice
- Address
- 2455 Route 516 Fl 1
Old Bridge, NJ 08857 - Phone
- (646) 203-6960
- Organisation at this address
- Kidzdent-Childrens Dental Care
Kidzdent Childrens Dental Center LlcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 6
Registry record
- Primary taxonomy
- 1223P0221X
1223P0221X
- Also registered as
- 390200000X
- Licence states on file
- NJ
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2021-05-17
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New Jersey