Individual provider Active NPI

Dimple Champaklal Maun, M.D.

  • Pediatrics Physician
  • Dover, NJ
National Provider Identifier
1033207410
Registry record updated Jul 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
082118 Issued in NJ
Practice address
369 W Blackwell St
Dover, NJ 07801-2560
Phone
(973) 328-8300
Fax
(866) 811-0251
NPI assigned
Oct 10, 2006
Last updated
Jul 16, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 082118 NJ Primary

Addresses

Primary practice location

369 W Blackwell St
Dover, NJ 07801-2560

Mailing address

809 Sun Valley Way
Florham Park, NJ 07932-3007
Phone (347) 439-3413

Other identifiers 1

IdentifierTypeStateIssuer
0141291MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
082118NJMDPediatrics Physician

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247702400000",
    "number": "1033207410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 SUN VALLEY WAY",
            "city": "FLORHAM PARK",
            "state": "NJ",
            "postal_code": "079323007",
            "telephone_number": "347-439-3413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "369 W BLACKWELL ST",
            "city": "DOVER",
            "state": "NJ",
            "postal_code": "078012560",
            "telephone_number": "973-328-8300",
            "fax_number": "866-811-0251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAUN",
        "first_name": "DIMPLE",
        "middle_name": "CHAMPAKLAL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2009-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "082118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0141291",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.