Individual provider Active NPI

Anton Pimanov, D.M.D

  • General Practice Dentistry
  • Edison, NJ
National Provider Identifier
1245623115
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02643200 Issued in NJ
Practice address
485 Route 1
Edison, NJ 08817-4491
Phone
(732) 985-4350
NPI assigned
Mar 16, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI02643200 NJ Primary

Addresses

Primary practice location

485 Route 1
Edison, NJ 08817-4491

Mailing address

485 Route 1
Edison, NJ 08817-4491
Phone (732) 985-4350

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
22DI02643200NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
We Brighten LLC PastSince Feb 9, 2025 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.

NPI Registry JSON

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

{
    "created_epoch": "1426464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468281600000",
    "number": "1245623115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "485 ROUTE 1",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088174491",
            "telephone_number": "732-985-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 ROUTE 1",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088174491",
            "telephone_number": "732-985-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIMANOV",
        "first_name": "ANTON",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-16",
        "last_updated": "2016-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02643200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; 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.