Individual provider Active NPI

Mohamed Samy Kamel, D.M.D, M.S., M.S.D

  • Prosthodontics
  • Newark, NJ
National Provider Identifier
1255636155
Registry record updated Apr 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
22DI02546200 Issued in NJ
Practice address
110 Bergen St
Newark, NJ 07103-2495
Phone
(973) 972-4615
NPI assigned
Jan 24, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 22DI02546200 NJ Primary

Addresses

Primary practice location

110 Bergen St
Newark, NJ 07103-2495

Mailing address

33 Summit St
West Orange, NJ 07052-1501

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170823003065 NJ Practitioner - Oral Surgery 2567734783

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Rutgers School of Dental Medicine CurrentSince Aug 1, 2017 Accepting new patients
Rutgers Health - RSDM Dental Associates - New Brunswick Os - NB CurrentSince Mar 27, 2022 Accepting new patients
Rutgers School of Dental Medicine CurrentSince Aug 1, 2017 Accepting new patients

Locations

135 Somerset St
Ste A
New Brunswick, NJ 08901
Phone (732) 235-5050

110 Bergen St
#B842A
Newark, NJ 07103

110 Bergen St
Newark, NJ 07103
Phone (973) 972-3126

110 Bergen St
#D718
Newark, NJ 07103
Phone (973) 972-4242

Organizations & group practices 3

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": "1295827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461542400000",
    "number": "1255636155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 SUMMIT ST",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032495",
            "telephone_number": "973-972-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMEL",
        "first_name": "MOHAMED",
        "middle_name": "SAMY",
        "credential": "D.M.D, M.S., M.S.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-01-24",
        "last_updated": "2016-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NJ",
            "license": "22DI02546200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.