Theodore Nicholas Constandelis, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11019 Issued in NJ

Practice address

465 Valley Rd
Clifton, NJ 07013-2234

Phone

(973) 684-1078

Fax

(973) 278-3128

NPI assigned

Jul 24, 2006

Sex

Male

Sole proprietor

Yes

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

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

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.

• Theodore N Constandelis

  • General Practice Dentistry
  • Clifton, NJ
  • NPI 1972712529
  NPD (past) Authorized official

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295757581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "465 VALLEY RD",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132234",
            "telephone_number": "973-684-1078",
            "fax_number": "973-278-3128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 VALLEY RD",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132234",
            "telephone_number": "973-684-1078",
            "fax_number": "973-278-3128"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSTANDELIS",
        "first_name": "THEODORE",
        "middle_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "11019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Coney Applied Behavior Analysis, PLLC
• Jeffrey C Conforti, DPM
• Daniel P Conroy Jr., M.D.
• Nicole Melissa Conroy, M.D.
• Dena Constandelis
• Fatima Lucila Constante-Gonzalez, O.D.,
• Elizabeth Jane Contarino, CNM
• Emily G Conte, LPC
• Convenient Care Center
• Jason G Cooney, DC

• General Practice Dentistry in Clifton, NJ
• Providers in Clifton, NJ by specialty
• General Practice Dentistry in New Jersey

• 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.

Verify at the official NPI Registry.