Individual provider Active NPI

Jeffrey Alan Mermelstein, D.M.D.

  • General Practice Dentistry
  • Livingston, NJ
National Provider Identifier
1316055478
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14163 Issued in NJ
Practice address
201 S Livingston Ave
Suite 2a
Livingston, NJ 07039-4043
Phone
(973) 992-0003
Fax
(973) 992-4644
NPI assigned
Aug 29, 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
General Practice Dentistry 1223G0001X 14163 NJ Primary

Addresses

Primary practice location

201 S Livingston Ave
Suite 2a
Livingston, NJ 07039-4043

Mailing address

201 S Livingston Ave
Suite 2a
Livingston, NJ 07039-4043
Phone (973) 992-0003

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
14163NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316055478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 S LIVINGSTON AVE",
            "address_2": "SUITE 2A",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394043",
            "telephone_number": "973-992-0003",
            "fax_number": "973-992-4644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 S LIVINGSTON AVE",
            "address_2": "SUITE 2A",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394043",
            "telephone_number": "973-992-0003",
            "fax_number": "973-992-4644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERMELSTEIN",
        "first_name": "JEFFREY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "14163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

  • 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.