Individual provider Active NPI

Maribell Vega, DDS

  • General Practice Dentistry
  • Perth Amboy, NJ
National Provider Identifier
1295017739
Registry record updated Apr 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02481900 Issued in NJ
Practice address
275 Hobart St
Perth Amboy, NJ 08861-3396
Phone
(732) 376-9333
Fax
(732) 324-7408
NPI assigned
Sep 11, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2014

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 22DI02481900 NJ Primary

Addresses

Primary practice location

275 Hobart St
Perth Amboy, NJ 08861-3396

Mailing address

275 Hobart St
Perth Amboy, NJ 08861-3396
Phone (732) 376-9333

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
I20160428000796 NJ Order and Referring Only - DentistPractitioner - Dentist 3072812825

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1315699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396828800000",
    "number": "1295017739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 HOBART ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613396",
            "telephone_number": "732-376-9333",
            "fax_number": "732-324-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 HOBART ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613396",
            "telephone_number": "732-376-9333",
            "fax_number": "732-324-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEGA",
        "first_name": "MARIBELL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-11",
        "last_updated": "2014-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02481900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

Verify at the official NPI Registry.