Provider Demographics
NPI:1174717631
Name:IN NETWORK DENTAL, LLC
Entity type:Organization
Organization Name:IN NETWORK DENTAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:
Authorized Official - Last Name:FEILER
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:201-342-2543
Mailing Address - Street 1:1060 MAIN ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-2591
Mailing Address - Country:US
Mailing Address - Phone:201-342-2543
Mailing Address - Fax:
Practice Address - Street 1:1060 MAIN ST
Practice Address - Street 2:SUITE 100
Practice Address - City:RIVER EDGE
Practice Address - State:NJ
Practice Address - Zip Code:07661-2591
Practice Address - Country:US
Practice Address - Phone:201-342-2543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IN NETWORK DENTAL, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-08-28
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02333100305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization