Provider Demographics
NPI:1568683977
Name:JOSEPH D. MIRANDA, D.M.D.
Entity type:Organization
Organization Name:JOSEPH D. MIRANDA, D.M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:MIRANDA
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:973-503-0988
Mailing Address - Street 1:279 WHIPPANY RD
Mailing Address - Street 2:
Mailing Address - City:WHIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07981-1941
Mailing Address - Country:US
Mailing Address - Phone:973-503-0988
Mailing Address - Fax:973-884-8724
Practice Address - Street 1:279 WHIPPANY RD
Practice Address - Street 2:
Practice Address - City:WHIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07981-1941
Practice Address - Country:US
Practice Address - Phone:973-503-0988
Practice Address - Fax:973-884-8724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI16158261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental