Individual provider Active NPI

Paul Lustiger, DDS

  • General Practice Dentistry
  • Jersey City, NJ
National Provider Identifier
1013938448
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16396 Issued in NJ
Practice address
1 Exchange PL
Suite 312
Jersey City, NJ 07302-3920
Phone
(201) 200-0500
Fax
(201) 200-1244
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 16396 NJ Primary

Addresses

Primary practice location

1 Exchange PL
Suite 312
Jersey City, NJ 07302-3920

Mailing address

1 Exchange PL
Suite 312
Jersey City, NJ 07302-3920
Phone (201) 200-0500

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150806010011 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4688988595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16396NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Paul Lustiger, DDS PA General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013938448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EXCHANGE PL",
            "address_2": "SUITE 312",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073023920",
            "telephone_number": "201-200-0500",
            "fax_number": "201-200-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EXCHANGE PL",
            "address_2": "SUITE 312",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073023920",
            "telephone_number": "201-200-0500",
            "fax_number": "201-200-1244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTIGER",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "16396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.