Vincent M Immordino, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI019357 Issued in NJ

Practice address

2273 Highway 33
Suite 201
Hamilton Square, NJ 08690-1747

Phone

(609) 588-0666

Fax

(609) 588-0421

NPI assigned

Oct 15, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 13, 2015 through Oct 13, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Vincent M. Immordino, DMD, PA

  • General Practice Dentistry
  • Hamilton Square, NJ
  • NPI 1134219454
  Authorized official Same address or phone

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

{
    "created_epoch": "1160870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326138645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2273 HIGHWAY 33",
            "address_2": "SUITE 201",
            "city": "HAMILTON SQUARE",
            "state": "NJ",
            "postal_code": "086901747",
            "telephone_number": "609-588-0666",
            "fax_number": "609-588-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2273 HIGHWAY 33",
            "address_2": "SUITE 201",
            "city": "HAMILTON SQUARE",
            "state": "NJ",
            "postal_code": "086901747",
            "telephone_number": "609-588-0666",
            "fax_number": "609-588-0421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMMORDINO",
        "first_name": "VINCENT",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI019357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Brian Heering, D.M.D.
• Josephine L Hines, PH.D.
• Cindy Lorz Hoge, DMD
• Jerome J Hric, M.D.
• Syed Hussain, DDS
• Joseph E Jenkins, DC
• Judy A Johns-Lozier, DDS
• Michele Noreen Kaguyutan, PHARMD
• Emma Karlin
• Daniel Scott Kessel, MD

• General Practice Dentistry in Hamilton Square, NJ
• Providers in Hamilton Square, NJ by specialty
• General Practice Dentistry in New Jersey

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.