Gloria E. Patino, D.M.D.

Individual provider Active NPI General Practice Dentistry · Wharton, NJ

NPI 1265655286 · NPPES record last updated Dec 2, 2011

Key facts

NPI
1265655286
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
D102155300 (NJ)
Practice address
400 S. Main St.
1St Floor
Wharton, NJ 07885-2043
Phone
(862) 397-4282
Fax
(862) 397-4285
NPI assigned
Apr 10, 2007
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
22DI02155300NJMDGeneral Practice Dentistry
D102155300NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
The Attentive Dentist, LLC General Practice Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI02155300 NJ
General Practice Dentistry 1223G0001X D102155300 NJ Yes

Addresses

Primary practice location

400 S. Main St.
1St Floor
Wharton, NJ 07885-2043

Mailing address

400 S. Main St.
1St Floor
Warton, NJ 07885-2043
Phone (862) 397-4282

Other providers in Wharton, NJ

All providers in Wharton, NJ · General Practice Dentistry in New Jersey

Sources for this page

Verify at the official NPI Registry.