Brad J. Convissar, DMD

General Practice Dentistry · Mount Laurel, NJ

Individual Active NPI

NPI number 1316009871

Practice location

2 Rancocas Blvd
Mount Laurel, NJ 08054-2057
Phone
(856) 778-8655
Fax
(856) 231-7480

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NPI record

NPI
1316009871
Entity type
Individual (Type 1)
Enumeration date
December 14, 2006
Last updated
December 31, 2021
Certified
December 31, 2021
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 22DI02233900 NJ

Mailing address

1950 Birchwood Park Dr N
Cherry Hill, NJ 08003-1026
Phone
(856) 751-1226

About Dr. Convissar

Brad J. Convissar, DMD is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 2 Rancocas Blvd, Mount Laurel, NJ 08054-2057. The NPI number 1316009871 was assigned on December 14, 2006 and the record was last updated on December 31, 2021.

Dr. Convissar lists a license in the registry: #22DI02233900 (NJ) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Brad J. Convissar, DMD?

The NPI number is 1316009871.

What is the phone number of Dr. Convissar?

The phone number listed for the practice location is (856) 778-8655.

Where is Dr. Convissar located?

2 Rancocas Blvd, Mount Laurel, NJ 08054-2057.

What is the taxonomy code for Dr. Convissar?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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