Individual provider Active NPI

Michael Dzitzer, DDS

  • General Practice Dentistry
  • Toms River, NJ
National Provider Identifier
1194941930
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI012677 Issued in NJ
Practice address
16 Washington St
Toms River, NJ 08753-7643
Phone
(732) 914-1039
NPI assigned
Apr 18, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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
General Practice Dentistry 1223G0001X 22DI012677 NJ Primary

Addresses

Primary practice location

16 Washington St
Toms River, NJ 08753-7643

Mailing address

16 Washington St
Toms River, NJ 08753-7643
Phone (732) 914-1039

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
I20160201000100 NJ Practitioner - Oral Surgery 9234433921 Practice locations: Somers Point, NJ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI012677NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194941930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 WASHINGTON ST",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087537643",
            "telephone_number": "732-914-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 WASHINGTON ST",
            "city": "TOMS RIVER",
            "state": "NJ",
            "postal_code": "087537643",
            "telephone_number": "732-914-1039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZITZER",
        "first_name": "MICHAEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI012677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toms River, NJ

Sources for this page

Verify at the official NPI Registry.