Poonam P Mashru, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02326300 Issued in NJ

Practice address

6200 Main St
Voorhees, NJ 08043-4629

Phone

(856) 751-6546

NPI assigned

Jan 29, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Burlington County Dental Associates

  • General Practice Dentistry
  • Cinnaminson, NJ
  • NPI 1689519043
  NPD Authorized official
• Family Dental Care of South Jersey

  • General Practice Dentistry
  • Voorhees, NJ
  • NPI 1457680225
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448064000000",
    "number": "1366588071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "707 HADDONFIELD BERLIN ROAD",
            "address_2": "UNIT B",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "08043",
            "telephone_number": "856-309-2244",
            "fax_number": "856-309-2247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 MAIN ST",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080434629",
            "telephone_number": "856-751-6546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASHRU",
        "first_name": "POONAM",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2015-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02326300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luisa Martins, PA-C
• Maryville, Inc.
• Maryville, Inc.
• Farouk Marzouk, M.D.
• Matthew Paul Maschio, DO
• Kristina Marie Masi, MD
• Malik Ali Massac, M.D.
• David Edward Massengale, CRNA
• Priya Mathew, DO
• Sheryl Mathew, MD

• General Practice Dentistry in Voorhees, NJ
• Providers in Voorhees, 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 Nov 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.