Michael Cicalese, DMD
Individual provider Active NPI General Practice Dentistry · Fairfield, NJ
NPI 1104056472 · NPPES record last updated Jul 21, 2009
Key facts
- NPI
- 1104056472
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DI021633 (NJ)
- Practice address
- 193 Fairfield Rd
Fairfield, NJ 07004-2472 - Phone
- (973) 227-0650
- Fax
- (973) 227-8148
- NPI assigned
- Jul 21, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI021633 | NJ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fairfield Dental Group | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DI021633 | NJ | Yes |
Addresses
Primary practice location
193 Fairfield Rd
Fairfield, NJ 07004-2472
Mailing address
193 Fairfield Rd
Fairfield, NJ 07004-2472
Phone (973) 227-0650
Other providers in Fairfield, NJ
- Jamie Elyce Chebuske
- Renee Checinski
- Devan Rae Chiusano
- Kristi Kay Ciacciarella
- Matthew Ciavarella
- Clearsteps ABA NJ LLC
- Rachael Clements
- Barry A. Cohen
- Christopher Cohron
- Nancyann Cole
All providers in Fairfield, NJ · General Practice Dentistry in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.