NPIMap

Organization Active NPI

Wyckoff-Nester, LLP

  • General Practice Dentistry
  • Wenonah, NJ
National Provider Identifier
1306049259
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11728 Issued in NJ
Legal business name
WYCKOFF-NESTER, LLP
Practice address
200 E Mantua Ave
Wenonah, NJ 08090-1921
Phone
(856) 468-5858
Fax
(856) 468-9098
NPI assigned
Jun 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Carl K Wyckoff III, D.D.S.NPI 1255365235
Title
Partner
Phone
(856) 468-5858

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 11728 NJ Primary

Addresses

Primary practice location

200 E Mantua Ave
Wenonah, NJ 08090-1921

Mailing address

200 E Mantua Ave
PO Box 37
Wenonah, NJ 08090-1921
Phone (856) 468-5858

Other identifiers 2

IdentifierTypeStateIssuer
1255365235OtherNJINDIVIDUAL
1225096712OtherNJINDIVIDUAL

National Provider Directory

National Provider Directory

Locations

200 E Mantua Ave
Wenonah, NJ 08090
Phone (856) 468-5858

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306049259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E MANTUA AVE",
            "address_2": "PO BOX 37",
            "city": "WENONAH",
            "state": "NJ",
            "postal_code": "080901921",
            "telephone_number": "856-468-5858",
            "fax_number": "856-468-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E MANTUA AVE",
            "city": "WENONAH",
            "state": "NJ",
            "postal_code": "080901921",
            "telephone_number": "856-468-5858",
            "fax_number": "856-468-9098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYCKOFF-NESTER, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WYCKOFF",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "856-468-5858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "11728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL",
            "identifier": "1255365235",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL",
            "identifier": "1225096712",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenonah, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.