Provider Demographics
NPI:1063134559
Name:PINTO, OLIVER (DMD)
Entity type:Individual
Prefix:
First Name:OLIVER
Middle Name:
Last Name:PINTO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 PAVONIA AVE APT 5207
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07306-3043
Mailing Address - Country:US
Mailing Address - Phone:786-590-8769
Mailing Address - Fax:
Practice Address - Street 1:407 39TH ST STE 401
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:NJ
Practice Address - Zip Code:07087-5367
Practice Address - Country:US
Practice Address - Phone:201-330-2837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI029320001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice