Main Street Family Dentistry, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

16152 Issued in NJ

Legal business name

MAIN STREET FAMILY DENTISTRY, PC

Practice address

76 N Main St
Medford, NJ 08055-2720

Phone

(609) 953-7199

NPI assigned

Jan 28, 2016

Last updated

Jan 28, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth S Hoover, DMDNPI 1861525065

Title

Owner

Phone

(609) 953-7199

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth Scott Hoover, D.M.D.

  • General Practice Dentistry
  • Medford, NJ
  • NPI 1861525065
  NPD Authorized official

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

{
    "created_epoch": "1453939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453939200000",
    "number": "1336506849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 N MAIN ST",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080552720",
            "telephone_number": "609-953-7199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 N MAIN ST",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080552720",
            "telephone_number": "609-953-7199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET FAMILY DENTISTRY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-28",
        "last_updated": "2016-01-28",
        "status": "A",
        "authorized_official_last_name": "HOOVER",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-953-7199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "16152",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": "16511",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joelle Lugo
• Michaela J Maffetone
• Amanda L Magana
• Allie Mager
• Collin Maier, LPC
• Madison Suzanna Maines, PA-C
• Egerton M Maitland, DDS
• Milagros Calderon Malicdem, M.D.
• Molly Malkinski
• Ellen Maniloff, M.ED, BCBA

• General Practice Dentistry in Medford, NJ
• Providers in Medford, 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 Jan 28, 2016; 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.