Songsakphisarn, Revadee

Songsakphisarn, Revadee is an individual health care provider with primary practice located at 846 Bergen Ave , Jersey City NJ 07306-4404. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Songsakphisarn, Revadee can be contacted via phone (201) 946-1000.

Contact Information

Primary practice address
846 Bergen Ave Jersey City NJ 07306-4404
Phone: (201) 946-1000
Fax: (201) 946-1641
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 19085 New Jersey

Profile Details

NPI number 1316935497
LBN Legal business name Songsakphisarn, Revadee
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 12th, 2005
Last updated Jul 13th, 2026 - about 4 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316935497 NPPES
New Jersey MEDICAID 6430201

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