Individual provider Active NPI

Luis Guillermo Molina, DMD

  • General Practice Dentistry
  • Union City, NJ
National Provider Identifier
1053469650
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02019000 Issued in NJ
Practice address
3600 Bergenline Ave
2ND FL
Union City, NJ 07087-7900
Phone
(201) 865-2788
Fax
(201) 865-0799
NPI assigned
Jan 8, 2007
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 22DI02019000 NJ Primary

Addresses

Primary practice location

3600 Bergenline Ave
2ND FL
Union City, NJ 07087-7900

Mailing address

3600 Bergenline Ave
2ND FL
Union City, NJ 07087-7900
Phone (201) 865-2788

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

LicenseStateTypeSpecialty
22DI02019000NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053469650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 BERGENLINE AVE",
            "address_2": "2ND FL",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070877900",
            "telephone_number": "201-865-2788",
            "fax_number": "201-865-0799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 BERGENLINE AVE",
            "address_2": "2ND FL",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070877900",
            "telephone_number": "201-865-2788",
            "fax_number": "201-865-0799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLINA",
        "first_name": "LUIS",
        "middle_name": "GUILLERMO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02019000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, 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.

Verify at the official NPI Registry.