Jason Michael Auerbach, DDS
Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · River Edge, NJ
NPI 1336112648 · NPPES record last updated Nov 6, 2007
Key facts
- NPI
- 1336112648
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- DI02230000 (NJ)
- Practice address
- 130 Kinderkamack Rd
Suite 204
River Edge, NJ 07661-1931 - Phone
- (201) 487-6565
- Fax
- (201) 487-4229
- NPI assigned
- Feb 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
- Opted out of Medicare
- Yes, effective Jul 10, 2014 through Jul 10, 2028
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI02230000 | NJ | MD | Oral and Maxillofacial Surgery (Dentist) |
| 048765-1 | NY | MD | Oral and Maxillofacial Surgery (Dentist) |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Riverside Oral Surgery- Englewood LLC | Oral and Maxillofacial Surgery | Current | Accepting new patients |
Locations
130 Kinderkamack Rd
Ste 204
River Edge, NJ 07661
Phone (201) 487-6565
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | DI02230000 | NJ | Yes |
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 048765-1 | NY |
Addresses
Primary practice location
130 Kinderkamack Rd
Suite 204
River Edge, NJ 07661-1931
Mailing address
130 Kinderkamack Rd
Suite 204
River Edge, NJ 07661-1931
Phone (201) 487-6565
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02289509 | Medicaid | NY |
Other providers in River Edge, NJ
- Angela Adams, MD, LLC
- Angela'S Angels Home Health Agency
- Lori G. Aram
- Erastus Wyman Archer
- Audiology Distribution, LLC
- Gene L Bascom
- Scarlett Bassily
- Herbert Daniel Benkel
- Bergen Obstetrical & Gynecological Assoc PA
- Ira Bernstein
All providers in River Edge, NJ · Oral and Maxillofacial Surgery (Dentist) in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 6, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.