Individual provider Active NPI

Dean J Vanover

  • Pharmacist
  • Wall Township, NJ
National Provider Identifier
1114195799
Registry record updated Feb 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI01572500 Issued in NJ
Practice address
2007 Highway 35
Wall Township, NJ 07719-3543
Phone
(732) 974-9290
Fax
(732) 974-5590
NPI assigned
Feb 15, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI01572500 NJ Primary

Addresses

Primary practice location

2007 Highway 35
Wall Township, NJ 07719-3543

Mailing address

308 Enterprise Dr
Forked River, NJ 08731-1815
Phone (732) 974-9290

Other identifiers 1

IdentifierTypeStateIssuer
28RI01572500OtherNJSTATE LICENSE NUMBER

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

State licenses

LicenseStateTypeSpecialty
28RI01572500NJMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203033600000",
    "number": "1114195799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "308 ENTERPRISE DR",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "087311815",
            "telephone_number": "732-974-9290",
            "fax_number": "732-974-5590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 HIGHWAY 35",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "077193543",
            "telephone_number": "732-974-9290",
            "fax_number": "732-974-5590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANOVER",
        "first_name": "DEAN",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-15",
        "last_updated": "2008-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI01572500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "28RI01572500",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wall Township, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; 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.