Individual provider Active NPI

Marvin A. Kornmehl, D.D.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Howell, NJ
National Provider Identifier
1053584417
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
22D101572800 Issued in NJ
Practice address
103 Candlewood Commons
Howell, NJ 07731-2168
Phone
(732) 364-1323
Fax
(732) 364-1322
NPI assigned
Apr 8, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 22D101572800 NJ Primary

Addresses

Primary practice location

103 Candlewood Commons
Howell, NJ 07731-2168

Mailing address

103 Candlewood Commons
Howell, NJ 07731-2168
Phone (732) 364-1323

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
22D101572800NJMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1053584417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CANDLEWOOD COMMONS",
            "city": "HOWELL",
            "state": "NJ",
            "postal_code": "077312168",
            "telephone_number": "732-364-1323",
            "fax_number": "732-364-1322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 CANDLEWOOD COMMONS",
            "city": "HOWELL",
            "state": "NJ",
            "postal_code": "077312168",
            "telephone_number": "732-364-1323",
            "fax_number": "732-364-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KORNMEHL",
        "first_name": "MARVIN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "22D101572800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Howell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.