Individual provider Active NPI

Robert Bruce Wolf, DDS

  • Prosthodontics
  • Lawrenceville, NJ
National Provider Identifier
1306038922
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
DI012054 Issued in NJ
Practice address
3131 Princeton Pike
Suite 1a
Lawrenceville, NJ 08648-2201
Phone
(609) 394-1670
Fax
(609) 895-1166
NPI assigned
Aug 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X DI012054 NJ Primary
Prosthodontics 1223P0700X 1223P0700X NJ

Addresses

Primary practice location

3131 Princeton Pike
Suite 1a
Lawrenceville, NJ 08648-2201

Mailing address

3131 Princeton Pike
Suite 1a
Lawrenceville, NJ 08648-2201
Phone (609) 394-1670

Other identifiers 1

IdentifierTypeStateIssuer
DI012054OtherNJLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1223P0700XNJMDProsthodontist
DI012054NJMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1306038922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 PRINCETON PIKE",
            "address_2": "SUITE 1A",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482201",
            "telephone_number": "609-394-1670",
            "fax_number": "609-895-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 PRINCETON PIKE",
            "address_2": "SUITE 1A",
            "city": "LAWRENCEVILLE",
            "state": "NJ",
            "postal_code": "086482201",
            "telephone_number": "609-394-1670",
            "fax_number": "609-895-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF",
        "first_name": "ROBERT",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-16",
        "last_updated": "2008-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NJ",
            "license": "DI012054",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NJ",
            "license": "1223P0700X",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "DI012054",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.