Individual provider Active NPI

Mark Joel Gelband, D.D.S.

  • Endodontics
  • Red Bank, NJ
National Provider Identifier
1093861940
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
22DI01126000 Issued in NJ
Practice address
200 Maple Ave
Red Bank, NJ 07701-1732
Phone
(732) 741-1567
Fax
(732) 741-3113
NPI assigned
Jan 25, 2007
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
Endodontics 1223E0200X 22DI01126000 NJ Primary

Addresses

Primary practice location

200 Maple Ave
Red Bank, NJ 07701-1732

Mailing address

200 Maple Ave
Red Bank, NJ 07701-1732
Phone (732) 741-1567

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
I20151106000451 NJ Order and Referring Only - DentistPractitioner - Dentist 3476863242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093861940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MAPLE AVE",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011732",
            "telephone_number": "732-741-1567",
            "fax_number": "732-741-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MAPLE AVE",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011732",
            "telephone_number": "732-741-1567",
            "fax_number": "732-741-3113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELBAND",
        "first_name": "MARK",
        "middle_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NJ",
            "license": "22DI01126000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

Verify at the official NPI Registry.