Charles Robert Becker
Individual provider Active NPI General Practice Dentistry · Ridgefield, NJ
NPI 1174648281 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1174648281
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DIO11694 (NJ)
- Practice address
- 473 Shaler Blvd
Ridgefield, NJ 07657-2424 - Phone
- (201) 945-9094
- NPI assigned
- Mar 20, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150722003404 | NJ | Order and Referring Only - Dentist |
0648583559 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DIO11694 | NJ | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DIO11694 | NJ | Yes |
Addresses
Primary practice location
473 Shaler Blvd
Ridgefield, NJ 07657-2424
Mailing address
473 Shaler Blvd
Ridgefield, NJ 07657-2424
Phone (201) 945-9094
Other providers in Ridgefield, NJ
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- Balanced Body Physical Therapy LLC
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- Dennis Barbieri
- Lauren Barroso
- Nicholas Berardo
- Bergen Arts Dental, PC
- Bergen Health and Wellness,LLC
- Frehiwot Berhanu
- Bethesda Acupuncture Clinic
All providers in Ridgefield, NJ · General Practice Dentistry in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.