Kerolos Nayrouz, DMD

Individual provider Active NPI General Practice Dentistry · Ewing, NJ

NPI 1235869652 · NPPES record last updated Nov 28, 2023

Key facts

NPI
1235869652
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
22DI02906900 (NJ)
Practice address
21 Scotch Rd
Ewing, NJ 08628-2512
Phone
(609) 435-3208
NPI assigned
Jun 16, 2022
Sex
Male
Sole proprietor
No

Organizations & group practices 2

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
22DI02906900NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Genuine Smiles PA General Practice Past
since Jun 1, 2022
Accepting new patients
Genuine Dental Management LLC General Practice Past
since Jun 1, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI02906900 NJ Yes

Addresses

Primary practice location

21 Scotch Rd
Ewing, NJ 08628-2512

Mailing address

2614 Fox Run Dr
Plainsboro, NJ 08536-2705
Phone (917) 588-3891

Other providers in Ewing, NJ

All providers in Ewing, NJ · General Practice Dentistry in New Jersey

Sources for this page

Verify at the official NPI Registry.