Active NPI
Robert A McKenna, DMD
- General Practice Dentistry
- Cedar Grove, NJ
National Provider Identifier
1043364359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 9686
- Practice address
- 466 Pompton Ave
Cedar Grove, NJ 07009-1812 - Phone
- (973) 857-0567
- Fax
- (973) 239-4456
- NPI assigned
- Jan 23, 2007
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 9686 | NJ | Primary |
Addresses
Primary practice location
466 Pompton Ave
Cedar Grove, NJ 07009-1812
Mailing address
466 Pompton Ave
Cedar Grove, NJ 07009-1812
Phone (973) 857-0567
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9686 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043364359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "466 POMPTON AVE",
"city": "CEDAR GROVE",
"state": "NJ",
"postal_code": "070091812",
"telephone_number": "973-857-0567",
"fax_number": "973-239-4456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "466 POMPTON AVE",
"city": "CEDAR GROVE",
"state": "NJ",
"postal_code": "070091812",
"telephone_number": "973-857-0567",
"fax_number": "973-239-4456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENNA",
"first_name": "ROBERT",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "9686",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cedar Grove, NJ
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.