Richard Champagne DMD PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

RICHARD CHAMPAGNE DMD PC

Practice address

480 Route 79
Morganville, NJ 07751-4090

Phone

(732) 972-0918

Fax

(732) 972-0044

NPI assigned

Dec 16, 2018

Organization subpart

No

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

Authorized official

Name

Lisa Ann Palasciano

Title

Financial Coordinhator

Phone

(732) 972-0918

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544918400000",
    "number": "1164993259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "480 ROUTE 79",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077514090",
            "telephone_number": "732-972-0918",
            "fax_number": "732-972-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "480 ROUTE 79",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077514090",
            "telephone_number": "732-972-0918",
            "fax_number": "732-972-0044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD CHAMPAGNE DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-16",
        "last_updated": "2018-12-16",
        "status": "A",
        "authorized_official_last_name": "PALASCIANO",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "FINANCIAL COORDINHATOR",
        "authorized_official_telephone_number": "732-972-0918"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2018; 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.