Jared Eli Maiman, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02443700 Issued in NJ

Practice address

1771 Madison Ave
Lakewood, NJ 08701

Phone

(732) 364-2144

Fax

(732) 364-3559

NPI assigned

Jul 9, 2009

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

Other identifiers 1

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 and National Provider Directory roles.

• Elegant Smiles of Matawan LLC

  • Dental Clinic/Center
  • Matawan, NJ
  • NPI 1689539652
  NPD Authorized official

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

{
    "created_epoch": "1247097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332892800000",
    "number": "1205065422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1771 MADISON AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "08701",
            "telephone_number": "732-364-2144",
            "fax_number": "732-364-3559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 MADISON AVE",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "08701",
            "telephone_number": "732-364-2144",
            "fax_number": "732-364-3559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAIMAN",
        "first_name": "JARED",
        "middle_name": "ELI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-09",
        "last_updated": "2012-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02443700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0251160",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mahadevan G Krishnan, MD PC
• Darshana Mahapatro, MD
• Mahmood-Schor Urology, P.a.
• Dina Maierovits, MS RD
• Susan L Mailman-Frid
• Mainstream ABA Support Services
• Makla Gestetner LCSW LLC
• Rina Malamud, BCBA
• Malcolm F. Kramer,DPM,PA
• Malkie Gold Rd LLC

• Dentist in Lakewood, NJ
• Providers in Lakewood, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2012; 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.