Provider Demographics
NPI:1053152231
Name:ABENANTE, LOUIS VINCENT (DMD)
Entity type:Individual
Prefix:DR
First Name:LOUIS
Middle Name:VINCENT
Last Name:ABENANTE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 SUNSET BLVD
Mailing Address - Street 2:
Mailing Address - City:LONGPORT
Mailing Address - State:NJ
Mailing Address - Zip Code:08403-1182
Mailing Address - Country:US
Mailing Address - Phone:609-442-3113
Mailing Address - Fax:
Practice Address - Street 1:214 NEW RD
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1214
Practice Address - Country:US
Practice Address - Phone:609-653-0980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI030317001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice