Individual provider Active NPI

Marc Anthony Cozzarin, DMD

  • Dentist
  • Lawrenceville, NJ
National Provider Identifier
1144312158
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DI16219 Issued in NJ
Practice address
96 Franklin Corner Rd
Lawrenceville, NJ 08648
Phone
(609) 896-0100
Fax
(609) 896-9046
NPI assigned
Sep 28, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DI16219 NJ Primary

Addresses

Primary practice location

96 Franklin Corner Rd
Lawrenceville, NJ 08648

Mailing address

96 Franklin Corner Rd
Lawrenceville, NJ 08648
Phone (609) 896-0100

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
I20150617002536 NJ Order and Referring Only - DentistPractitioner - Dentist 2163733189

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI16219NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Franklin Corner Dental Group PA PastSince Apr 16, 2023 Accepting new patients
Franklin Corner Dental Associates PA PastSince Jun 23, 2015 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144312158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 FRANKLIN CORNER RD",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "08648",
            "telephone_number": "609-896-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 FRANKLIN CORNER RD",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "08648",
            "telephone_number": "609-896-0100",
            "fax_number": "609-896-9046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COZZARIN",
        "first_name": "MARC",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI16219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, NJ

Sources for this page

Verify at the official NPI Registry.