Active NPI
Mal Azar, DMD
- Pediatric Dentistry
- Jersey City, NJ
National Provider Identifier
1003286378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DI02641500
- Practice address
- 88 Morgan St
Jersey City, NJ 07302-1427 - Phone
- (201) 451-6727
- NPI assigned
- Sep 30, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DI02641500 | NJ | Primary |
Addresses
Primary practice location
88 Morgan St
Jersey City, NJ 07302-1427
Mailing address
88 Morgan St
Jersey City, NJ 07302-1427
Phone (201) 451-6727
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170120000070 | NY | Order and Referring Only - Other (Physician) | 2466734892 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI02641500 | NJ | MD | Pediatric Dentist |
| 058673 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1443571200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480896000000",
"number": "1003286378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "88 MORGAN ST",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073021427",
"telephone_number": "201-451-6727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "88 MORGAN ST",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073021427",
"telephone_number": "201-451-6727"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AZAR",
"first_name": "MAL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-09-30",
"last_updated": "2016-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NJ",
"license": "DI02641500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jersey City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.