Individual provider Active NPI

Robert S. Fiedler, DMD

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Linwood, NJ
National Provider Identifier
1104860196
Registry record updated Jul 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
17511 Issued in NJ
Practice address
199 New Rd
Central Square Suite 32
Linwood, NJ 08221-2025
Phone
(609) 927-9090
Fax
(609) 927-9091
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 17511 NJ Primary

Addresses

Primary practice location

199 New Rd
Central Square Suite 32
Linwood, NJ 08221-2025

Mailing address

199 New Rd
Central Square Suite 32
Linwood, NJ 08221-2025
Phone (609) 927-9090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
17511NJMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Benaifer D. Preziosi, LLC PastSince Jun 15, 2017 Accepting new patients

Organizations & group practices 1

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1104860196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 NEW RD",
            "address_2": "CENTRAL SQUARE SUITE 32",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082212025",
            "telephone_number": "609-927-9090",
            "fax_number": "609-927-9091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "199 NEW RD",
            "address_2": "CENTRAL SQUARE SUITE 32",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082212025",
            "telephone_number": "609-927-9090",
            "fax_number": "609-927-9091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIEDLER",
        "first_name": "ROBERT",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NJ",
            "license": "17511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Linwood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.