Individual provider Active NPI

John Alvin Fizer, DDS

  • Dentist
  • Trenton, NJ
National Provider Identifier
1194872929
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22D100929800 Issued in NJ
Practice address
414 Market St
Trenton, NJ 08611-1712
Phone
(609) 989-7088
Fax
(609) 989-8884
NPI assigned
Jan 4, 2007
Sex
Male
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
Dentist 122300000X 22D100929800 NJ Primary

Addresses

Primary practice location

414 Market St
Trenton, NJ 08611-1712

Mailing address

414 Market St
Trenton, NJ 08611-1712
Phone (609) 989-7088

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
I20150511000183 NJ Order and Referring Only - DentistPractitioner - Dentist 4981923133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22D100929800NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194872929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 MARKET ST",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086111712",
            "telephone_number": "609-989-7088",
            "fax_number": "609-989-8884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 MARKET ST",
            "city": "TRENTON",
            "state": "NJ",
            "postal_code": "086111712",
            "telephone_number": "609-989-7088",
            "fax_number": "609-989-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIZER",
        "first_name": "JOHN",
        "middle_name": "ALVIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22D100929800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trenton, NJ

Sources for this page

Verify at the official NPI Registry.