Carl Angelo Bifano, DMD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

22D102457901 Issued in NJ

Practice address

2 Plaza Dr Ste 202
Sewell, NJ 08080

Phone

(856) 270-4100

NPI assigned

May 5, 2006

Last updated

Apr 1, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Cooper Surgical Associates

  • Urology Physician
  • Cherry Hill, NJ
  • NPI 1083732143
  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554076800000",
    "number": "1124076500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FEDERAL ST STE SW200",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081031155",
            "telephone_number": "856-356-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 PLAZA DR STE 202",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "08080",
            "telephone_number": "856-270-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 E Lehigh Ave",
            "address_2": "PM2",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191251011",
            "country_code": "US",
            "telephone_number": "215-707-3613",
            "fax_number": "215-707-5405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BIFANO",
        "first_name": "CARL",
        "middle_name": "ANGELO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2019-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "MD",
            "license": "6833",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NJ",
            "license": "DI02457900",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "PA",
            "license": "DS019214L",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "NJ",
            "license": "22D102457901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1025303770001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "DS019214L",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DI02457900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert J Bernstein, DMD
• Erin Berry, RN
• James R Bertel, MD
• Between the Lines: a Clinic Offering Reading, Speech Language, and Occ (Between the Lines)
• Nicholas Andrew Bianco, DO
• Daniel Bigini
• Sandra H Bispo, MD
• Ellen Louise Bleidorn, PT
• Edward Andrew Bley Jr., DO
• Craig Bober

• Oral & Maxillofacial Surgery (D.M.D.) in Sewell, NJ
• Providers in Sewell, NJ by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2019; 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.