Individual provider Active NPI

Mario Severino Fiorentini, DMD

  • Dentist
  • Highland Park, NJ
National Provider Identifier
1093735706
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Practice address
85 Woodbridge Ave
Highland Park, NJ 08904-3207
Phone
(732) 545-1023
Fax
(732) 572-5855
NPI assigned
Jul 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NJ Primary

Addresses

Primary practice location

85 Woodbridge Ave
Highland Park, NJ 08904-3207

Mailing address

85 Woodbridge Ave
Highland Park, NJ 08904-3207
Phone (732) 545-1023

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150619000571 NJ Order and Referring Only - DentistPractitioner - Dentist 7113238957

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DIO1352800NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Central Jersey Dental Sleep Medicine at FFDG LLC Dentist CurrentSince Jun 1, 2020 Accepting new patients
Mario S Fiorentini DMD PA Dentist Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093735706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 WOODBRIDGE AVE",
            "city": "HIGHLAND PARK",
            "state": "NJ",
            "postal_code": "089043207",
            "telephone_number": "732-545-1023",
            "fax_number": "732-572-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 WOODBRIDGE AVE",
            "city": "HIGHLAND PARK",
            "state": "NJ",
            "postal_code": "089043207",
            "telephone_number": "732-545-1023",
            "fax_number": "732-572-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIORENTINI",
        "first_name": "MARIO",
        "middle_name": "SEVERINO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, NJ

Sources for this page

Verify at the official NPI Registry.