Individual provider Active NPI

Virginia Matos-Perrotte, DMD

  • Dentist
  • New Brunswick, NJ
National Provider Identifier
1144202110
Registry record updated Jun 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DIO1497200 Issued in NJ
Practice address
277 George St
New Brunswick, NJ 08901-1311
Phone
(732) 235-6700
NPI assigned
Nov 16, 2005
Last updated
Jun 2, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DIO1497200 NJ Primary

Addresses

Primary practice location

277 George St
New Brunswick, NJ 08901-1311

Mailing address

361 Grandview Ave
Piscataway, NJ 08854
Phone (732) 369-3764

Other identifiers 1

IdentifierTypeStateIssuer
003469MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20231218003306 NJ Order and Referring Only - DentistPractitioner - Dentist 9032400445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DIO1497200NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1144202110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "361 GRANDVIEW AVE",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "08854",
            "telephone_number": "732-369-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 GEORGE ST",
            "city": "NEW BRUNSWICK",
            "state": "NJ",
            "postal_code": "089011311",
            "telephone_number": "732-235-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATOS-PERROTTE",
        "first_name": "VIRGINIA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-16",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DIO1497200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003469",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brunswick, NJ

Sources for this page

Verify at the official NPI Registry.