South Jersey Center for Advanced Dentistry, LLC
NPI 1760006209ActiveOrganization· Dentist, Prosthodontics· Marlton, NJ
Dentist, Prosthodontics in Marlton, New Jersey, registered in NPPES in June 2020. The authorized official on file is Laderrick Bullock, DMD, Owner.
Overview
| NPI | 1760006209 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 1, 2020 |
| Last updated in NPPES | Jun 1, 2020 |
| Certified by provider | Jun 1, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Prosthodontics Primary | 1223P0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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