Michael Steven Cappuccilli, D.D.S.

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

D121111 Issued in NJ

Practice address

13 Somerdale SQ
Somerdale, NJ 08083-1345

Phone

(856) 566-6016

Fax

(856) 566-6012

NPI assigned

Apr 19, 2006

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

Other identifiers 1

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

Practice roles

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.

• Rutgers School of Dental Medicine

  • Dental Clinic/Center
  • Somerdale, NJ
  • NPI 1831302504
  NPD (past)

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1467417659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 N RINGGOLD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191301943",
            "telephone_number": "215-232-2531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 SOMERDALE SQ",
            "city": "SOMERDALE",
            "state": "NJ",
            "postal_code": "080831345",
            "telephone_number": "856-566-6016",
            "fax_number": "856-566-6012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAPPUCCILLI",
        "first_name": "MICHAEL",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "NJ",
            "license": "D121111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0018341",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Everett Thomas Chadwick, RNFA
• Desmond Cheng, DO
• CMD Mental Health Professional, Inc
• Sean W. Comp, PT, DPT

• Public Health Dentistry in Somerdale, NJ
• Providers in Somerdale, NJ by specialty
• Public Health Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.