Active NPI
Judith Anne Kimmelman, D.M.D.
- General Practice Dentistry
- Penns Grove, NJ
National Provider Identifier
1396889523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DI017520
- Practice address
- 31 W Main St
Penns Grove, NJ 08069-1348 - Phone
- (856) 299-1096
- Fax
- (856) 299-4222
- NPI assigned
- Feb 19, 2007
- Last updated
- Jun 17, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DI017520 | NJ | Primary |
Addresses
Primary practice location
31 W Main St
Penns Grove, NJ 08069-1348
Mailing address
5 Stoney Hill LN
Mount Laurel, NJ 08054-2903
Phone (856) 206-9480
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
| License | State | Type | Specialty |
|---|---|---|---|
| DI017520 | NJ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Penns Grove Family Dental LLC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Practice Dentistry
- Penns Grove, NJ
- NPI 1760800346
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371427200000",
"number": "1396889523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 STONEY HILL LN",
"city": "MOUNT LAUREL",
"state": "NJ",
"postal_code": "080542903",
"telephone_number": "856-206-9480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "31 W MAIN ST",
"city": "PENNS GROVE",
"state": "NJ",
"postal_code": "080691348",
"telephone_number": "856-299-1096",
"fax_number": "856-299-4222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMMELMAN",
"first_name": "JUDITH",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-19",
"last_updated": "2013-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "DI017520",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Penns Grove, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 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.