Individual provider Active NPI

Joseph B Pino, DMD

  • General Practice Dentistry
  • Mount Laurel, NJ
National Provider Identifier
1073523023
Registry record updated Sep 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
16996 Issued in NJ
Practice address
1200 S Church St
Mount Laurel, NJ 08054-2936
Phone
(856) 234-9003
Fax
(856) 234-8097
NPI assigned
Aug 9, 2006
Last updated
Sep 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2013

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 16996 NJ Primary

Addresses

Primary practice location

1200 S Church St
Mount Laurel, NJ 08054-2936

Mailing address

1200 S Church St
Mount Laurel, NJ 08054-2936
Phone (856) 234-9003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Mar 15, 2016 through Mar 15, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16996NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1073523023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 S CHURCH ST",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542936",
            "telephone_number": "856-234-9003",
            "fax_number": "856-234-8097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 S CHURCH ST",
            "city": "MOUNT LAUREL",
            "state": "NJ",
            "postal_code": "080542936",
            "telephone_number": "856-234-9003",
            "fax_number": "856-234-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINO",
        "first_name": "JOSEPH",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "16996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Laurel, NJ

Sources for this page

Verify at the official NPI Registry.