Frank Vincent Maldonado, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI15752 Issued in NJ

Practice address

95 Packanack Lake Rd
Wayne, NJ 07470-7420

Phone

(973) 694-8625

Fax

(973) 872-0073

NPI assigned

Jan 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1396896171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 PACKANACK LAKE RD",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074707420",
            "telephone_number": "973-694-8625",
            "fax_number": "973-872-0073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 PACKANACK LAKE RD",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074707420",
            "telephone_number": "973-694-8625",
            "fax_number": "973-872-0073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "FRANK",
        "middle_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI15752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Faisal Mahmood, MD
• James W Mahon, MD
• Herbert Simon Maier, M.D.
• Mailly Consulting Inc
• Kenneth Howard Mailly, P.T.
• Wilson Maldonado, D.M.D
• Mark E Maletsky, MD
• Joanne Malysa, OT
• Andrei M Manalang, PT
• Nicholas Joseph Mangone Jr., PT, DPT

• General Practice Dentistry in Wayne, NJ
• Providers in Wayne, 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 Jul 8, 2007; 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.