Individual provider Active NPI

Robert Paul Praisner, DMD

  • General Practice Dentistry
  • Chester, NJ
National Provider Identifier
1154543205
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17956 Issued in NJ
Practice address
55 Collis LN
Chester, NJ 07930-2204
Phone
(908) 879-5912
Fax
(908) 879-5912
NPI assigned
May 2, 2007
Sex
Male
Sole proprietor
Yes

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
General Practice Dentistry 1223G0001X 17956 NJ Primary

Addresses

Primary practice location

55 Collis LN
Chester, NJ 07930-2204

Mailing address

55 Collis LN
P.O. Box 43
Chester, NJ 07930-2204
Phone (908) 879-5912

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
17956NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154543205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 COLLIS LN",
            "address_2": "P.O. BOX 43",
            "city": "CHESTER",
            "state": "NJ",
            "postal_code": "079302204",
            "telephone_number": "908-879-5912",
            "fax_number": "908-879-5912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 COLLIS LN",
            "city": "CHESTER",
            "state": "NJ",
            "postal_code": "079302204",
            "telephone_number": "908-879-5912",
            "fax_number": "908-879-5912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRAISNER",
        "first_name": "ROBERT",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "17956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.