Victor H. Train, D.D.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

13089 Issued in NJ

Practice address

390 State Route 10
Suite 102
Randolph, NJ 07869-2141

Phone

(973) 361-6180

Fax

(973) 361-6087

NPI assigned

Apr 20, 2007

Last updated

Mar 7, 2023By the provider in NPPES

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

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

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1245457001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 STATE ROUTE 10",
            "address_2": "SUITE 102",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692141",
            "telephone_number": "973-361-6180",
            "fax_number": "973-361-6087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 STATE ROUTE 10",
            "address_2": "SUITE 102",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078692141",
            "telephone_number": "973-361-6180",
            "fax_number": "973-361-6087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAIN",
        "first_name": "VICTOR",
        "middle_name": "H.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "13089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "13089",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Periodontics in Randolph, NJ
• Providers in Randolph, NJ by specialty
• Periodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.