Active NPI
Steven A. Campolattaro, D.M.D.
- Periodontics
- Succasunna, NJ
National Provider Identifier
1235290222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- DI18734
- Practice address
- 22 State Route 10 W
Suite 102
Succasunna, NJ 07876-1731 - Phone
- (973) 598-1601
- Fax
- (973) 598-1618
- NPI assigned
- Dec 13, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | DI18734 | NJ | Primary |
Addresses
Primary practice location
22 State Route 10 W
Suite 102
Succasunna, NJ 07876-1731
Mailing address
22 State Route 10 W
Suite 102
Succasunna, NJ 07876-1731
Phone (973) 598-1601
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI18734 | NJ | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeside Endodontics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Endodontics
- Succasunna, NJ
- NPI 1972727253
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235290222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 STATE ROUTE 10 W",
"address_2": "SUITE 102",
"city": "SUCCASUNNA",
"state": "NJ",
"postal_code": "078761731",
"telephone_number": "973-598-1601",
"fax_number": "973-598-1618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 STATE ROUTE 10 W",
"address_2": "SUITE 102",
"city": "SUCCASUNNA",
"state": "NJ",
"postal_code": "078761731",
"telephone_number": "973-598-1601",
"fax_number": "973-598-1618"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMPOLATTARO",
"first_name": "STEVEN",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NJ",
"license": "DI18734",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Succasunna, NJ
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.