NPIMap

Organization Active NPI

Otilia Marticorena, DMD, PC

  • Dentist
  • Elizabeth, NJ
National Provider Identifier
1093147266
Registry record updated Jul 30, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI01915100 Issued in NJ
Legal business name
OTILIA MARTICORENA, DMD, PC
Practice address
768 Newark Ave
Elizabeth, NJ 07208-3536
Phone
(908) 355-8555
Fax
(908) 355-8590
NPI assigned
Jul 30, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2013

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

Authorized official

Name
Dr. Otilia Marticorena, DMDNPI 1528119849
Title
President- Dentist
Phone
(908) 355-8555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 22DI01915100 NJ Primary

Addresses

Primary practice location

768 Newark Ave
Elizabeth, NJ 07208-3536

Mailing address

768 Newark Ave
Elizabeth, NJ 07208-3536
Phone (908) 355-8555

National Provider Directory

National Provider Directory

Locations

768 Newark Ave
Elizabeth, NJ 07208
Phone (908) 355-8555

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1375142400000",
    "number": "1093147266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "768 NEWARK AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083536",
            "telephone_number": "908-355-8555",
            "fax_number": "908-355-8590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "768 NEWARK AVE",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072083536",
            "telephone_number": "908-355-8555",
            "fax_number": "908-355-8590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OTILIA MARTICORENA, DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-30",
        "last_updated": "2013-07-30",
        "status": "A",
        "authorized_official_last_name": "MARTICORENA",
        "authorized_official_first_name": "OTILIA",
        "authorized_official_title_or_position": "PRESIDENT- DENTIST",
        "authorized_official_telephone_number": "908-355-8555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI01915100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.