Active NPI
Magda Khalil-Douedi, DMD
- General Practice Dentistry
- Toms River, NJ
National Provider Identifier
1275621898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DI17001
- Practice address
- 437 Lakehurst Rd
Toms River, NJ 08755-7378 - Phone
- (732) 505-5300
- NPI assigned
- Oct 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DI17001 | NJ | Primary |
Addresses
Primary practice location
437 Lakehurst Rd
Toms River, NJ 08755-7378
Mailing address
1842 Charlton Cir
Toms River, NJ 08755-1481
Phone (732) 505-1190
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150701001787 | NJ | Order and Referring Only - Dentist | 6406001494 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI17001 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1275621898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1842 CHARLTON CIR",
"city": "TOMS RIVER",
"state": "NJ",
"postal_code": "087551481",
"telephone_number": "732-505-1190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "437 LAKEHURST RD",
"city": "TOMS RIVER",
"state": "NJ",
"postal_code": "087557378",
"telephone_number": "732-505-5300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHALIL-DOUEDI",
"first_name": "MAGDA",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "DI17001",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Toms River, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.