OrganizationActive
Children'S Dental Surgery Center of Jackson LLC
NPI 1710552278 · Ambulatory Surgical Clinic/Center · Jackson, NJ
Provider details
- NPI number
- 1710552278
- Entity type
- Organization
- Primary specialty
- Ambulatory Surgical Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Van Phi Le, Credentialing Contracts Manager(267) 575-2321
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(62/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
27 S Cooks Bridge Rd Ste 2-3
Jackson, NJ 08527-2462
Phone: (732) 928-1099
Fax: (732) 833-1690
Street-level locationGet directions
Mailing address
300 Willowbrook Ln Ste 330
West Chester, PA 19382-5594
Other names (DBA / former)
- Doing business as
- Children'S Dental Surgery of Jackson
- Doing business as
- Children'S Dental Surgery of Jackson
Registry dates
- Enumerated
- 2021-05-26
- Last updated
- 2022-08-24
- Certified
- 2022-08-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.