Individual provider Active NPI

David Brody, D.M.D.

  • Dentist
  • Marlboro, NJ
National Provider Identifier
1417905415
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI00984100 Issued in NJ
Practice address
81 Wyncrest Rd
Marlboro, NJ 07746-2248
Phone
(732) 536-6666
Fax
(732) 536-1229
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI00984100 NJ Primary

Addresses

Primary practice location

81 Wyncrest Rd
Marlboro, NJ 07746-2248

Mailing address

81 Wyncrest Rd
Marlboro, NJ 07746-2248
Phone (732) 536-6666

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
I20150521002134 NJ Order and Referring Only - DentistPractitioner - Dentist 5698095289

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI00984100NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1417905415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 WYNCREST RD",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077462248",
            "telephone_number": "732-536-6666",
            "fax_number": "732-536-1229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 WYNCREST RD",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077462248",
            "telephone_number": "732-536-6666",
            "fax_number": "732-536-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODY",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI00984100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlboro, NJ

Sources for this page

Verify at the official NPI Registry.