Marc Joseph Pukenas, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DI 02299000 Issued in NJ

Practice address

3069 English Creek Ave
Suite #304
Egg Harbor Township, NJ 08234-9708

Phone

(609) 645-1900

Fax

(609) 645-8441

NPI assigned

May 1, 2007

Sex

Male

Sole proprietor

Yes

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 and National Provider Directory roles.

• Atlantic Smiles LLC

  • Dental Clinic/Center
  • Egg Harbor Township, NJ
  • NPI 1023273695
  NPD (past) Authorized official

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294099200000",
    "number": "1215158142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3069 ENGLISH CREEK AVE",
            "address_2": "SUITE #304",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082349708",
            "telephone_number": "609-645-1900",
            "fax_number": "609-645-8441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3069 ENGLISH CREEK AVE",
            "address_2": "SUITE #304",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082349708",
            "telephone_number": "609-645-1900",
            "fax_number": "609-645-8441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUKENAS",
        "first_name": "MARC",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2011-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI 02299000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra R Price
• Tara Price, CRNP FNP-C
• Primary Housecall Providers, LLC
• Principle Academy Charter School
• Pristine Care & Support Services LLC
• Qualcare Dental Associates, P.a.
• Lauren Quinones
• Amanda Elizabeth Quo, MOT, OTR/L
• Heather Rachinsky
• Qamarah Ragsdale, LCSW

• Dentist in Egg Harbor Township, NJ
• Providers in Egg Harbor Township, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2011; 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.