Individual provider Active NPI

Marc Joseph Nardea, DMD

  • Pediatric Dentistry
  • Teaneck, NJ
National Provider Identifier
1114480324
Registry record updated May 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
22DI02830700 Issued in NJ
Practice address
751 Teaneck Rd
Teaneck, NJ 07666
Phone
(201) 837-1612
NPI assigned
Apr 14, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Dentistry 1223P0221X 22DI02830700 NJ Primary

Addresses

Primary practice location

751 Teaneck Rd
Teaneck, NJ 07666

Mailing address

260 W 26TH St Apt 10L
New York, NY 10001-0136
Phone (908) 309-4845

Other practice location 1

160 E Erie Ave
Philadelphia, PA 19134-1011
Phone (215) 427-5065

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
22DI02830700NJMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Marc Nardea DMD PLLC Pediatric Dentistry CurrentSince Dec 22, 2024 Accepting new patients

Locations

347 5th Ave
Rm 1210
New York, NY 10016
Phone (401) 589-5864

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": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1114480324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 W 26TH ST APT 10L",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100010136",
            "telephone_number": "908-309-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "751 TEANECK RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "07666",
            "telephone_number": "201-837-1612"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "160 E Erie Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191341011",
            "country_code": "US",
            "telephone_number": "215-427-5065",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NARDEA",
        "first_name": "MARC",
        "middle_name": "JOSEPH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-14",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02830700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2022; 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.