Individual provider Active NPI

Elliot Baron, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Red Bank, NJ
National Provider Identifier
1346215472
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DI22550 Issued in NJ
Practice address
50 Wallace St
Red Bank, NJ 07701-1861
Phone
(732) 747-0993
Fax
(732) 747-0961
NPI assigned
Feb 22, 2006
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
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DI22550 NJ Primary

Addresses

Primary practice location

50 Wallace St
Red Bank, NJ 07701-1861

Mailing address

45 Dune Rd
Wayside, NJ 07712-3766
Phone (732) 757-6250

Other identifiers 1

IdentifierTypeStateIssuer
0046515MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150721000322 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1759305253

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI22550NJMDOral and Maxillofacial Surgery (Dentist)

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346215472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 DUNE RD",
            "city": "WAYSIDE",
            "state": "NJ",
            "postal_code": "077123766",
            "telephone_number": "732-757-6250",
            "fax_number": "732-747-0961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 WALLACE ST",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011861",
            "telephone_number": "732-747-0993",
            "fax_number": "732-747-0961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARON",
        "first_name": "ELLIOT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "DI22550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0046515",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

Verify at the official NPI Registry.