Individual provider Active NPI

Wayne Todd Faber, DMD

  • Dentist
  • Tenafly, NJ
National Provider Identifier
1336270503
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DL01125500 Issued in NJ
Practice address
2 Dean Dr
Tenafly, NJ 07670-2765
Phone
(201) 871-4505
NPI assigned
Mar 8, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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 22DL01125500 NJ Primary

Addresses

Primary practice location

2 Dean Dr
Tenafly, NJ 07670-2765

Mailing address

22 Evergreen PL
Tenafly, NJ 07670-2806
Phone (201) 568-2954

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
22DL01125500NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1336270503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 EVERGREEN PL",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076702806",
            "telephone_number": "201-568-2954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DEAN DR",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076702765",
            "telephone_number": "201-871-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABER",
        "first_name": "WAYNE",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DL01125500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tenafly, 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.