Individual provider Active NPI

Donna Fassman, DDS

  • Dentist
  • Manalapan, NJ
National Provider Identifier
1124237250
Registry record updated Mar 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI01810300 Issued in NJ
Practice address
3 Elizabeth PL
Manalapan, NJ 07726-3661
Phone
(732) 446-9230
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 042019 NY
Dentist 122300000X 22DI01810300 NJ Primary

Addresses

Primary practice location

3 Elizabeth PL
Manalapan, NJ 07726-3661

Mailing address

3 Elizabeth PL
Manalapan, NJ 07726-3661
Phone (732) 446-9230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150817001553 NY Order and Referring Only - DentistPractitioner - Dentist 2769797901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI01810300NJMDDentist
042019NYMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267574400000",
    "number": "1124237250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 ELIZABETH PL",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077263661",
            "telephone_number": "732-446-9230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 ELIZABETH PL",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077263661",
            "telephone_number": "732-446-9230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FASSMAN",
        "first_name": "DONNA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2010-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "042019",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI01810300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manalapan, NJ

Sources for this page

Verify at the official NPI Registry.