Monika Maria Waclaw, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019031099 Issued in IL

Practice address

600 Getty Ave
Clifton, NJ 07011-2161

Phone

(973) 594-6931

NPI assigned

Jun 4, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

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

{
    "created_epoch": "1496534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1245768274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 GETTY AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070112161",
            "telephone_number": "630-450-6893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 GETTY AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070112161",
            "telephone_number": "973-594-6931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6440 Main St Ste 310",
            "address_purpose": "LOCATION",
            "city": "Woodridge",
            "state": "IL",
            "postal_code": "60517",
            "country_code": "US",
            "telephone_number": "630-241-3904",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "811 W Wellington Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606575123",
            "country_code": "US",
            "telephone_number": "773-975-1600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WACLAW",
        "first_name": "MONIKA",
        "middle_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-04",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019031099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Walgreen Co

• Dentist in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; 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.