Active NPI
David Saul Ehrenberg, DDS, MS
- Prosthodontics
- Teaneck, NJ
National Provider Identifier
1477692127
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 12760
- Practice address
- 162 Grayson PL
Teaneck, NJ 07666-4714 - Phone
- (120) 183-6116
- NPI assigned
- Feb 6, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 12760 | NJ | Primary |
Addresses
Primary practice location
162 Grayson PL
Teaneck, NJ 07666-4714
Mailing address
162 Grayson PL
Teaneck, NJ 07666-4714
Phone (120) 183-6116
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150629002862 | NJ | Order and Referring Only - Other (Physician) | 7416269725 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12760 | NJ | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1477692127",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "162 GRAYSON PL",
"city": "TEANECK",
"state": "NJ",
"postal_code": "076664714",
"telephone_number": "120-183-6116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "162 GRAYSON PL",
"city": "TEANECK",
"state": "NJ",
"postal_code": "076664714",
"telephone_number": "120-183-6116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EHRENBERG",
"first_name": "DAVID",
"middle_name": "SAUL",
"name_prefix": "Dr.",
"credential": "DDS, MS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "NJ",
"license": "12760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Teaneck, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.