Individual provider Active NPI

Paul Poli, DMD

  • Dentist
  • Parlin, NJ
National Provider Identifier
1316017734
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
13087 Issued in NJ
Practice address
777 Washington Rd
St 4
Parlin, NJ 08859-1074
Phone
(732) 257-2000
Fax
(732) 257-2606
NPI assigned
Nov 9, 2006
Sex
Male
Sole proprietor
No

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
Dentist 122300000X 13087 NJ Primary

Addresses

Primary practice location

777 Washington Rd
St 4
Parlin, NJ 08859-1074

Mailing address

7 Allen CT
Manaladan, NJ 07726-8926
Phone (732) 236-4662

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
I20161206000269 NJ Order and Referring Only - DentistPractitioner - Dentist 5294015418

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13087NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316017734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 ALLEN CT",
            "city": "MANALADAN",
            "state": "NJ",
            "postal_code": "077268926",
            "telephone_number": "732-236-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 WASHINGTON RD",
            "address_2": "ST 4",
            "city": "PARLIN",
            "state": "NJ",
            "postal_code": "088591074",
            "telephone_number": "732-257-2000",
            "fax_number": "732-257-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLI",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "13087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parlin, NJ

Sources for this page

Verify at the official NPI Registry.