MAGIC DENTAL CAMDEN, LLC (NPI# 1235610882) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235610882 |
| Entity Type | Organization |
| Organization Name | MAGIC DENTAL CAMDEN, LLC |
| Practice Address |
433 Market St Ste 102 Camden NJ 08102-1572 |
| Practice Telephone | 8569632369 |
| Practice Fax Number | 8569632369 |
| Mailing Telephone | 8569632369 |
| Mailing Fax Number | 8569632369 |
| Enumeration Date | 2018-08-22 |
| Last Update Date | 2020-06-12 |
| Authorized Official Name | DR. NATALYA KONDRATYEVA (OWNER) |
| Authorized Official Telephone | 8569630315 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
22DI02018400 | NJ | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NJ | 0617415 | 05 |
| Street Address |
433 MARKET ST STE 102 |
| City | CAMDEN |
| State | NJ |
| Zip Code | 08102-1572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316936479 | Natalya Kondratyeva | Dentist | 433 Market St Ste 102, Camden, NJ 08102 | 2005-10-20 |
| 1184779985 | Mds Management, Inc. | Dentist | 433 Market St Ste 102, Camden, NJ 08102-1572 | 2007-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760992432 | Gracious Smiles, Inc. | Dentist | 121 Market St., Camden, NJ 08102 | 2017-10-06 |
| 1982154837 | Karl William Medley Sr. | Health Educator | 330 Federal St., Camden County Dept. of Corrections- Second Chance, Camden, NJ 08102 | 2016-10-04 |
| 1023445699 | Northeast Pain Management | Clinic/Center | 1 Market St. #1c, Camden, NJ 08102 | 2013-09-27 |
| 1235309915 | John D Holtsclaw | Specialist | 424 Market Street, Camden, NJ 08102 | 2008-03-10 |
| 1225207780 | Camcare Health Corporation | Clinic/Center | 6th and Erie Street, Camden, NJ 08102 | 2008-02-28 |
| 1376729681 | Dean J. Pulcini | Social Worker | 530 Cooper St., Costar Center, Camden, NJ 08102 | 2008-01-16 |
| 1760525489 | Rxd Pharmacy of Nj Inc | Pharmacy | 1805 Broadway, A&b Drugs, Camden, NJ 08102 | 2007-02-14 |
| 1114068236 | Lyda Cervantes Monte | Psychiatry & Neurology | 427 Market Street, Nueva Vida Behavioral Health Center of N.j., Camden, NJ 08102 | 2007-02-09 |
| 1467806935 | Michael Waak | Social Worker | 330 Federal Street, Camden County Department of Corrections, Camden, NJ 08102 | 2016-04-20 |
| 1639408867 | Annmarie Panarello | Counselor | 326 Penn St, Camden, NJ 08102 | 2009-12-17 |
| Find all providers in zip 08102 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861989261 | Elizabeth N Himel | Dentist | 2235 W Dekalb St, Camden, SC 29020-2070 | 2018-04-20 |
| 1760992432 | Gracious Smiles, Inc. | Dentist | 121 Market St., Camden, NJ 08102 | 2017-10-06 |
| 1831598846 | Estate of William J Biggins | Dentist | 1015 Fair Street, Camden, SC 29020 | 2014-08-14 |
| 1487917001 | Taylor Donald Everett | Dentist | 604 Ja Dooley Womack Dr, Camden, AR 71701-2730 | 2012-06-19 |
| 1831330737 | Amelia Jo Dinwiddie | Dentist | 116 Vicksburg Ave, Camden, TN 38320-1614 | 2009-03-23 |
| 1376753988 | Cathy Moss | Dentist | 310 Hampton Park, Camden, SC 29020-3605 | 2007-05-23 |
| 1760609739 | Robert L. Carter | Dentist | 1436 Haddon Ave, Camden, NJ 08103-3111 | 2007-04-19 |
| 1275659120 | Hal Joseph Angeloff | Dentist | 431 Kaighns Ave, Camden, NJ 08103-2209 | 2007-03-22 |
| 1922138742 | Edna Lazetta Giles-williams | Dentist | 400 Rutledge St, Camden, SC 29020-4423 | 2007-03-07 |
| 1669513271 | Marshall I Mitchell Dds | Dentist | 142 Haynes, Camden, AR 71701 | 2007-02-08 |
| Find all providers in CAMDEN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.