Individual provider Active NPI

Alyssa Rae Nielubowicz, D.M.D.

  • General Practice Dentistry
  • Cherry Hill, NJ
National Provider Identifier
1386909398
Registry record updated Dec 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS039174 Issued in PA
Practice address
401 Kings Hwy S
Suite 2a
Cherry Hill, NJ 08034-2500
Phone
(856) 429-4600
NPI assigned
Jul 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS039174 PA Primary

Addresses

Primary practice location

401 Kings Hwy S
Suite 2a
Cherry Hill, NJ 08034-2500

Mailing address

401 Kings Hwy S
Suite 2a
Cherry Hill, NJ 08034-2500
Phone (856) 429-4600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS039174PAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Zonies-Holgado Dental Assoc., PA General Practice Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387152000000",
    "number": "1386909398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 KINGS HWY S",
            "address_2": "SUITE 2A",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342500",
            "telephone_number": "856-429-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 KINGS HWY S",
            "address_2": "SUITE 2A",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080342500",
            "telephone_number": "856-429-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELUBOWICZ",
        "first_name": "ALYSSA",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-06",
        "last_updated": "2013-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS039174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cherry Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2013; 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.