Active NPI
Stacy Rebecca Gurbarg, DDS
- Dentist
- Montville, NJ
National Provider Identifier
1063973014
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22DI02795600
- Practice address
- 150 River Rd Ste D
Montville, NJ 07045-9441 - Phone
- (973) 926-7000
- NPI assigned
- Mar 30, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 22DI02795600 | NJ | Primary |
Addresses
Primary practice location
150 River Rd Ste D
Montville, NJ 07045-9441
Mailing address
150 River Rd Ste D
Montville, NJ 07045-9441
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 |
|---|---|---|---|
| 22DI02795600 | NJ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553904000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696291200000",
"number": "1063973014",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 RIVER RD STE D",
"city": "MONTVILLE",
"state": "NJ",
"postal_code": "070459441"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 RIVER RD STE D",
"city": "MONTVILLE",
"state": "NJ",
"postal_code": "070459441",
"telephone_number": "973-926-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GURBARG",
"first_name": "STACY",
"middle_name": "REBECCA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-03-30",
"last_updated": "2023-10-03",
"certification_date": "2023-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22DI02795600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montville, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.