Individual provider Active NPI

Brian Charles Cunningham, DMD

  • General Practice Dentistry
  • Clifton, NJ
National Provider Identifier
1467462705
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI01355800 Issued in NJ
Practice address
1070 Clifton Ave
Clifton, NJ 07013-3619
Phone
(973) 778-3344
Fax
(973) 778-7812
NPI assigned
Aug 9, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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 22DI01355800 NJ Primary

Addresses

Primary practice location

1070 Clifton Ave
Clifton, NJ 07013-3619

Mailing address

1070 Clifton Ave
Clifton, NJ 07013-3619
Phone (973) 778-3344

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
I20231204001745 NJ Order and Referring Only - DentistPractitioner - Dentist 0749500015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph F. Kennedy, Jr. D.M.D. Brian Cunningham, D.M.D., P.a. 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.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467462705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133619",
            "telephone_number": "973-778-3344",
            "fax_number": "973-778-7812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 CLIFTON AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133619",
            "telephone_number": "973-778-3344",
            "fax_number": "973-778-7812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "BRIAN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI01355800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.