Individual provider Active NPI

Stanley G. Yeager, D.M.D., P.A.

  • General Practice Dentistry
  • Montville, NJ
National Provider Identifier
1285770552
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22D100954400 Issued in NJ
Practice address
112 Main Rd
Montville, NJ 07045-9223
Phone
(973) 335-9432
Fax
(973) 335-3504
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22D100954400 NJ Primary

Addresses

Primary practice location

112 Main Rd
Montville, NJ 07045-9223

Mailing address

112 Main Rd
Montville, NJ 07045-9223
Phone (973) 335-9432

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
I20160512000731 NJ Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 9638468705

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
22D100954400NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285770552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 MAIN RD",
            "city": "MONTVILLE",
            "state": "NJ",
            "postal_code": "070459223",
            "telephone_number": "973-335-9432",
            "fax_number": "973-335-3504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MAIN RD",
            "city": "MONTVILLE",
            "state": "NJ",
            "postal_code": "070459223",
            "telephone_number": "973-335-9432",
            "fax_number": "973-335-3504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEAGER",
        "first_name": "STANLEY",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "D.M.D., P.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22D100954400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montville, NJ

Sources for this page

Verify at the official NPI Registry.