Courtney Michelson Pantirer, D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

22DI02874600 Issued in NJ

Practice address

110 Bergen St
Newark, NJ 07103-2495

Phone

(973) 972-4242

NPI assigned

Oct 29, 2014

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Mar 17, 2016 through Mar 17, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• East Cooper Dental Excellence

  • Dentist
  • Mt Pleasant, SC
  • NPI 1669680948
  NPD (past)

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

{
    "created_epoch": "1414540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675814400000",
    "number": "1265837553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 WELLS LN",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070782843",
            "telephone_number": "504-250-7887"
        },
        {
            "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": "973-972-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTIRER",
        "first_name": "COURTNEY",
        "middle_name": "MICHELSON",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-29",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22DI02874600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Manish Bharat Pandya, PHARMD
• Ryan Anthony Panetti, MD
• Patricia Ann Panfile, APN
• Silvana Panfili, RD
• Anna Panjikaran
• Nikitha Lovely Pappachen, DO
• Ashok Para, MD
• Ali Sajjad Paracha
• Nancy Paradis, APRN-BC
• Aimee Parado

• Periodontics in Newark, NJ
• Providers in Newark, NJ by specialty
• Periodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2023; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.