Individual provider Active NPI

Lawrence Patrick Duca Jr., D.M.D.

  • General Practice Dentistry
  • Clifton, NJ
National Provider Identifier
1063565612
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI01607200 Issued in NJ
Practice address
347 Valley Rd
Clifton, NJ 07013-1344
Phone
(973) 278-8181
Fax
(973) 278-3225
NPI assigned
Jan 18, 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 22DI01607200 NJ Primary

Addresses

Primary practice location

347 Valley Rd
Clifton, NJ 07013-1344

Mailing address

347 Valley Rd
Clifton, NJ 07013-1344
Phone (973) 278-8181

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
I20150727000846 NJ Order and Referring Only - DentistPractitioner - Dentist 3971817560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI01607200NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063565612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 VALLEY RD",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131344",
            "telephone_number": "973-278-8181",
            "fax_number": "973-278-3225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 VALLEY RD",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070131344",
            "telephone_number": "973-278-8181",
            "fax_number": "973-278-3225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCA",
        "first_name": "LAWRENCE",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI01607200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.