Stan R Mahan Jr., D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

14420 Issued in NJ

Practice address

2494 Moore Rd
Suite 2
Toms River, NJ 08753-8187

Phone

(732) 255-8844

Fax

(732) 255-0544

NPI assigned

May 3, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013139484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2494 MOORE RD",
            "address_2": "SUITE 2",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087538187",
            "telephone_number": "732-255-8844",
            "fax_number": "732-255-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2494 MOORE RD",
            "address_2": "SUITE 2",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087538187",
            "telephone_number": "732-255-8844",
            "fax_number": "732-255-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHAN",
        "first_name": "STAN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "14420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma A Magierski
• Magnolia Gardens South LP
• Priscilla Magsalin Alberto, M.D.
• James J Maguire
• Shannon Mahan
• Ramesh Chandra Mahapatro, M.D.
• Jacklyn Sara Mahgerefteh, DO
• Mahmood-Schor Urology, P.a.
• Parvez Mahmood, M.D.
• Neivein Mahmoud, BACB 1-22-61317

• Dentist in Toms River, NJ
• Providers in Toms River, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.