NPIMap

Organization Active NPI

McDonnel&Dazen PA

  • General Practice Dentistry
  • Mount Holly, NJ
National Provider Identifier
1265541296
Registry record updated Dec 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DI16147 Issued in NJ
Legal business name
MCDONNEL&DAZEN PA
Practice address
120 Madison Ave
Suite a
Mount Holly, NJ 08060-2039
Phone
(609) 267-7323
Fax
(609) 267-8744
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2013

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

Authorized official

Name
Dr. Anne Pfarrer Dazen, DMD
Title
President
Phone
(609) 267-7323

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DI16147 NJ Primary

Addresses

Primary practice location

120 Madison Ave
Suite a
Mount Holly, NJ 08060-2039

Mailing address

120 Madison Ave
Suite a
Mount Holly, NJ 08060-2039
Phone (609) 267-7323

National Provider Directory

National Provider Directory

Locations

120 Madison Ave
Ste A
Mount Holly, NJ 08060
Phone (609) 267-7323

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386892800000",
    "number": "1265541296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MADISON AVE",
            "address_2": "SUITE A",
            "city": "MOUNT HOLLY",
            "state": "NJ",
            "postal_code": "080602039",
            "telephone_number": "609-267-7323",
            "fax_number": "609-267-8744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 MADISON AVE",
            "address_2": "SUITE A",
            "city": "MOUNT HOLLY",
            "state": "NJ",
            "postal_code": "080602039",
            "telephone_number": "609-267-7323",
            "fax_number": "609-267-8744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCDONNEL&DAZEN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2013-12-13",
        "status": "A",
        "authorized_official_last_name": "DAZEN",
        "authorized_official_first_name": "ANNE",
        "authorized_official_middle_name": "PFARRER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-267-7323",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI16147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Holly, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2013; 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.