Individual provider Active NPI

Cheryl J Goren Robins, DDS

  • Periodontics
  • Millburn, NJ
National Provider Identifier
1164446365
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
22DI01929900 Issued in NJ
Practice address
75 Main St
Suite 107
Millburn, NJ 07041-1367
Phone
(973) 467-5567
Fax
(973) 467-5639
NPI assigned
Jul 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
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
Periodontics 1223P0300X 22DI01929900 NJ Primary

Addresses

Primary practice location

75 Main St
Suite 107
Millburn, NJ 07041-1367

Mailing address

75 Main St
Suite 107
Millburn, NJ 07041-1367
Phone (973) 467-5567

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
I20150609000232 NJ Order and Referring Only - DentistPractitioner - Dentist 4385897180

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Periodontics and Implants LLC Periodontics Current Accepting new patients

Locations

75 Main St
Ste 107
Millburn, NJ 07041
Phone (201) 919-0418

Organizations & group practices 1

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164446365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 MAIN ST",
            "address_2": "SUITE 107",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411367",
            "telephone_number": "973-467-5567",
            "fax_number": "973-467-5639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MAIN ST",
            "address_2": "SUITE 107",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411367",
            "telephone_number": "973-467-5567",
            "fax_number": "973-467-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOREN ROBINS",
        "first_name": "CHERYL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22DI01929900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millburn, NJ

Sources for this page

Verify at the official NPI Registry.