Individual provider Active NPI

Gary Jay Friedland, D.D.S.

  • General Practice Dentistry
  • Turnersville, NJ
National Provider Identifier
1144376302
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DI011502 Issued in NJ
Practice address
188 Fries Mill Rd Ste L3
Turnersville, NJ 08012-2055
Phone
(856) 629-0088
Fax
(856) 875-6828
NPI assigned
Jan 28, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DI011502 NJ Primary

Addresses

Primary practice location

188 Fries Mill Rd Ste L3
Turnersville, NJ 08012-2055

Mailing address

69 Twin Ponds Dr
Sewell, NJ 08080-2710
Phone (856) 582-1160

Other identifiers 1

IdentifierTypeStateIssuer
6015409MedicaidNJ

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
DI011502NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1169942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1144376302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 TWIN PONDS DR",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802710",
            "telephone_number": "856-582-1160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "188 FRIES MILL RD STE L3",
            "city": "TURNERSVILLE",
            "state": "NJ",
            "postal_code": "080122055",
            "telephone_number": "856-629-0088",
            "fax_number": "856-875-6828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIEDLAND",
        "first_name": "GARY",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-28",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI011502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6015409",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Turnersville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.