John Julius Fahsbender III, D.M.D.

Individual provider Active NPI General Practice Dentistry · Middlesex, NJ

NPI 1467566166 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1467566166
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
11256 (NJ)
Practice address
101 Union Ave
Middlesex, NJ 08846-1039
Phone
(732) 356-1313
Fax
(732) 356-1092
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160311000317 NJ Order and Referring Only - General Practice
Practitioner - General Practice
6103122528

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
11256NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Upper Cervical Chiropractic of New Jersey LLC Past
since Feb 6, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 11256 NJ Yes

Addresses

Primary practice location

101 Union Ave
Middlesex, NJ 08846-1039

Mailing address

28 Kilmer Dr
Hillsborough, NJ 08844-3830
Phone (908) 874-0524

Other providers in Middlesex, NJ

All providers in Middlesex, NJ · General Practice Dentistry in New Jersey

Sources for this page

Verify at the official NPI Registry.