Aaron Prestup, D.M.D

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

09460 Issued in NJ

Practice address

1030 Saint Georges Ave
Avenel, NJ 07001-1390

Phone

(732) 750-0707

NPI assigned

Apr 7, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Eastern Periodontic Associates, LLC

  • Periodontics
  • Avenel, NJ
  • NPI 1093876658
  Authorized official Same address or phone
• Eastern Dental of Laurel Springs, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Laurel Springs, NJ
  • NPI 1154448744

  Periodontics

  NPD (past)
• Eastern Dental of Vineland, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Vineland, NJ
  • NPI 1033236625

  Periodontics

  NPD (past)

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

{
    "created_epoch": "1175904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184747016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 SAINT GEORGES AVE",
            "city": "AVENEL",
            "state": "NJ",
            "postal_code": "070011390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 SAINT GEORGES AVE",
            "city": "AVENEL",
            "state": "NJ",
            "postal_code": "070011390",
            "telephone_number": "732-750-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTUP",
        "first_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "09460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sally-Jo Placa, DMD, MPA
• Alla Podokshik, D.D.S
• Ankita Prasad, MD
• Precious Life Medical Services LLC
• Precious Perinatology LLC (Precious Perinatology Imaging & Treatment)
• Jessica F Puchalski, OTR/L
• Q E-Z Transportation
• Tabeer Qazi
• Patrick Quaranta, D.M.D
• Quest Mental Health and Crisis Counseling Corp.

• Periodontics in Avenel, NJ
• Providers in Avenel, NJ by specialty
• Periodontics in New Jersey

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.