Individual provider Active NPI

Douglas R. Mahler, DMD

  • Dentist
  • Fair Lawn, NJ
National Provider Identifier
1245383744
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI01536800 Issued in NJ
Practice address
25-15 Fair Lawn Ave
2ND Floor
Fair Lawn, NJ 07410-3434
Phone
(201) 797-8464
Fax
(201) 797-6882
NPI assigned
Jan 19, 2007
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
Dentist 122300000X 22DI01536800 NJ Primary

Addresses

Primary practice location

25-15 Fair Lawn Ave
2ND Floor
Fair Lawn, NJ 07410-3434

Mailing address

25-15 Fair Lawn Ave
2ND Floor
Fair Lawn, NJ 07410-3434
Phone (201) 797-8464

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

LicenseStateTypeSpecialty
22DI01536800NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245383744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25-15 FAIR LAWN AVE",
            "address_2": "2ND FLOOR",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103434",
            "telephone_number": "201-797-8464",
            "fax_number": "201-797-6882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25-15 FAIR LAWN AVE",
            "address_2": "2ND FLOOR",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074103434",
            "telephone_number": "201-797-8464",
            "fax_number": "201-797-6882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHLER",
        "first_name": "DOUGLAS",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI01536800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, 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.

Verify at the official NPI Registry.