Individual provider Active NPI

Monika O'Brien, DMD

  • Dentist
  • Sewell, NJ
National Provider Identifier
1376974477
Registry record updated Dec 31, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DIO2279100 Issued in NJ
Practice address
468 Hurffville Crosskeys Rd
Atrium II, Suite1
Sewell, NJ 08080-2322
Phone
(856) 553-6514
Fax
(856) 553-6519
NPI assigned
Nov 29, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DIO2279100 NJ Primary

Addresses

Primary practice location

468 Hurffville Crosskeys Rd
Atrium II, Suite1
Sewell, NJ 08080-2322

Mailing address

468 Hurffville Crosskeys Rd
Atrium II, Suite1
Sewell, NJ 08080-2322
Phone (856) 553-6514

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
I20160613000192 NJ Order and Referring Only - DentistPractitioner - Dentist 1759671290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DIO2279100NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1385683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388448000000",
    "number": "1376974477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 HURFFVILLE CROSSKEYS RD",
            "address_2": "ATRIUM II, SUITE1",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802322",
            "telephone_number": "856-553-6514",
            "fax_number": "856-553-6519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 HURFFVILLE CROSSKEYS RD",
            "address_2": "ATRIUM II, SUITE1",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802322",
            "telephone_number": "856-553-6514",
            "fax_number": "856-553-6519"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "MONIKA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-29",
        "last_updated": "2013-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DIO2279100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

Verify at the official NPI Registry.