Benjamin L Pomeranc, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02449500 Issued in NJ

Practice address

700 N Broad St Ste 101
Elizabeth, NJ 07208-2310

Phone

(973) 563-9414

NPI assigned

Jul 28, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

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

{
    "created_epoch": "1280275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1083928345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 TARLTON DR",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070392411",
            "telephone_number": "973-563-9414",
            "fax_number": "732-914-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 N BROAD ST STE 101",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072082310",
            "telephone_number": "973-563-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POMERANC",
        "first_name": "BENJAMIN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-28",
        "last_updated": "2022-01-04",
        "certification_date": "2022-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI024495",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02449500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0262561",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marc Steven Plotkin, D.D.S.
• PMC Drugs LLC (Icarerx Pharmacy)
• Fred A Podbielak, OPTHALMIC DISPENSER
• Yaminah Polanco
• Catherine B Polera, DO
• Delores Ponton, LSW
• Monika Poselek
• Miguel B. Pou, DDS
• Kerri Lynette Powell, MD
• Tannavi Prakash

• General Practice Dentistry in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.