Michael Depaolo

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02826900 Issued in NJ

Practice address

2046 W County Line Rd Ste 2
Jackson, NJ 08527-2034

Phone

(732) 905-2488

NPI assigned

Apr 7, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Michael Depaolo, DMD, LLC

  • General Practice Dentistry
  • Red Bank, NJ
  • NPI 1801772009

  Single Specialty

  NPD Authorized official
• Select Dental Jackson LLC

  • General Practice Dentistry
  • Jackson, NJ
  • NPI 1235026485

  Single Specialty

  NPD

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645488000000",
    "number": "1316576754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2046 W COUNTY LINE RD STE 2",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272034",
            "telephone_number": "732-905-2488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2046 W COUNTY LINE RD STE 2",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085272034",
            "telephone_number": "732-905-2488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPAOLO",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-07",
        "last_updated": "2022-02-22",
        "certification_date": "2022-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02826900",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Elizabeth Dejesus, LMT
• Sylvia Ivette Dejesus
• Peter Joseph Demuro, DO
• Melisa Dennis
• Megan Dent
• Developmental Disabilities Association of NJ Inc.
• Devereux Advanced Behavioral Health
• Christina Rose Di Vincenzo, BCBA
• Shoshana Diamond
• Falinda C Dieujuste, LCSW

• Dentist in Jackson, NJ
• Providers in Jackson, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2022; 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.