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201 Oral Surgery

Oral surgery practice in Old Tappan, NJ

Registered specialistLicense # listed (NJ)

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Public-record details

Address
180 Old Tappan Rd, Old Tappan, NJ 07675
Phone
(201) 767-4001
Listed under
Oral & maxillofacial surgeons, Specialty practices
NPI
1073896809
NPI status
Active in the NPPES registry
Provider type
Organization (practice, clinic or company)
Registered specialty (self-reported taxonomy)
Oral and Maxillofacial Surgery (1223S0112X)
License number on NPI record
22DI02332400 (NJ)
Authorized official
Suzanne Waltke, Office Manager
NPI first issued
Sep 28, 2011
NPI record last updated
Sep 28, 2011

NPI 1073896809 is active in the federal NPPES registry (CMS) with Oral and Maxillofacial Surgery, an ADA-recognized dental specialty, as its primary taxonomy; license 22DI02332400 (NJ) is listed on the record. Source: NPPES NPI Registry (CMS) (record). Data as of 2026-09-30.

What these registry facts mean

The NPI (National Provider Identifier) is the federal ID every HIPAA-covered provider uses to bill insurance. This NPI belongs to an organization, so it may cover several clinicians at this location. The specialty is the taxonomy the provider chose when registering; NPPES does not check it. A license number here is what the provider entered — confirm it with the state board before you rely on it. Oral and maxillofacial surgeons are trained in surgery of the mouth and jaws, including placing implants, extractions, bone grafts and sinus lifts, and in anesthesia. Dentists who are not specialists can also place implants; the specialty here is the one the provider registered as primary.

View NPI 1073896809 in the official registry ↗

Checking credentials: the specialty shown is the one this provider registered with the NPI system. Your state dental board's license lookup confirms the license, and the American Board of Prosthodontics, the American Board of Oral and Maxillofacial Surgery and the American Board of Periodontology each list their board-certified members.