Benjamin A Maldonado Jr., DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DI19327 Issued in NJ

Practice address

576 Springfield Ave
Berkeley Heights, NJ 07922-1055

Phone

(908) 464-5630

Fax

(908) 464-6297

NPI assigned

May 22, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Berkeley Periodontics LLC

  • Periodontics
  • Berkeley Heights, NJ
  • NPI 1730392630
  NPD (past) Authorized official

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211414400000",
    "number": "1063679454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 SPRINGFIELD AVE",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079221055",
            "telephone_number": "908-464-5630",
            "fax_number": "908-464-6297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 SPRINGFIELD AVE",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079221055",
            "telephone_number": "908-464-5630",
            "fax_number": "908-464-6297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "BENJAMIN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "DI19327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antonio Macias, M.D.
• Nicole Mack, MS CCC-SLP
• Brian M Mackey, O.D.
• Marissa Faith Maddalena, PA-C
• Karen Lynn Magliacano
• Daphney Malone, RPA-C
• Soma Mandal, M.D.
• Ellen D Mandel, PA
• Saad Mansuri
• Jennifer Marianne Marchitto, AU.D.

• Periodontics in Berkeley Heights, NJ
• Providers in Berkeley Heights, NJ by specialty
• Periodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.