Individual provider Active NPI

Christopher J Kulas, DMD

  • Dentist
  • Medford, NJ
National Provider Identifier
1114076320
Registry record updated Jun 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
21868 Issued in NJ
Practice address
308 Tuckerton Road
Medford, NJ 08055
Phone
(609) 654-2454
Fax
(609) 654-6568
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 21868 NJ Primary

Addresses

Primary practice location

308 Tuckerton Road
Medford, NJ 08055

Mailing address

308 Tuckerton Road
Medford, NJ 08055
Phone (609) 654-2454

Other identifiers 1

IdentifierTypeStateIssuer
21868MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Apr 18, 2019 through Apr 18, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21868NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Medford Family Dental Care PA Dentist Past 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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309132800000",
    "number": "1114076320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 TUCKERTON ROAD",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "08055",
            "telephone_number": "609-654-2454",
            "fax_number": "609-654-6568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "308 TUCKERTON ROAD",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "08055",
            "telephone_number": "609-654-2454",
            "fax_number": "609-654-6568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULAS",
        "first_name": "CHRISTOPHER",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2011-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "21868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "21868",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NJ

Sources for this page

Verify at the official NPI Registry.