Individual provider Active NPI

Corina Atanase, DMD

  • Dentist
  • Chatham, NJ
National Provider Identifier
1346393717
Registry record updated Sep 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02372900 Issued in NJ
Practice address
33 Main Street
Ste. 101
Chatham, NJ 07928-2314
Phone
(973) 635-0626
Fax
(973) 507-9395
NPI assigned
Jan 19, 2007
Last updated
Sep 8, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02372900 NJ Primary
General Practice Dentistry 1223G0001X 8669 CT

Addresses

Primary practice location

33 Main Street
Ste. 101
Chatham, NJ 07928-2314

Mailing address

33 Main Street
Ste. 101
Chatham, NJ 07928-2314
Phone (973) 635-0626

Other identifiers 1

IdentifierTypeStateIssuer
22DI02372900OtherNJSTATE LICENSE #

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
I20170217001423 NJ Order and Referring Only - DentistPractitioner - Dentist 7214119866

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8669CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dentistry of Summit, LLC CurrentSince Feb 23, 2012 Accepting new patients

Locations

33 Main St
Ste 101
Chatham, NJ 07928
Phone (973) 635-0626

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315440000000",
    "number": "1346393717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 MAIN STREET",
            "address_2": "STE. 101",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079282314",
            "telephone_number": "973-635-0626",
            "fax_number": "973-507-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 MAIN STREET",
            "address_2": "STE. 101",
            "city": "CHATHAM",
            "state": "NJ",
            "postal_code": "079282314",
            "telephone_number": "973-635-0626",
            "fax_number": "973-507-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATANASE",
        "first_name": "CORINA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2011-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02372900",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "8669",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "22DI02372900",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chatham, NJ

Sources for this page

Verify at the official NPI Registry.