Individual provider Active NPI

Marc Jeffrey Weinberger, DMD

  • General Practice Dentistry
  • Bordentown, NJ
National Provider Identifier
1457477846
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18702 Issued in NJ
Practice address
15 Crosswicks St
Bordentown, NJ 08505-1736
Phone
(609) 298-1238
Fax
(609) 298-8522
NPI assigned
Mar 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 18702 NJ Primary

Addresses

Primary practice location

15 Crosswicks St
Bordentown, NJ 08505-1736

Mailing address

15 Crosswicks St
Bordentown, NJ 08505-1736
Phone (609) 298-1238

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
I20160520000531 NJ Order and Referring Only - DentistPractitioner - Dentist 6305135948

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18702NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1457477846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 CROSSWICKS ST",
            "city": "BORDENTOWN",
            "state": "NJ",
            "postal_code": "085051736",
            "telephone_number": "609-298-1238",
            "fax_number": "609-298-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CROSSWICKS ST",
            "city": "BORDENTOWN",
            "state": "NJ",
            "postal_code": "085051736",
            "telephone_number": "609-298-1238",
            "fax_number": "609-298-8522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEINBERGER",
        "first_name": "MARC",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "18702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bordentown, NJ

Sources for this page

Verify at the official NPI Registry.