Radu Myron Lupsa, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

22D101896100 Issued in NJ

Practice address

16 Skyline Lakes Dr
Ste #8
Ringwood, NJ 07456

Phone

(973) 839-3434

Fax

(973) 839-1366

NPI assigned

Aug 12, 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 names 1

• Myron Radu Lupsa Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 3, 2015 through Dec 3, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487666053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 SKYLINE LAKES DR",
            "address_2": "STE #8",
            "city": "RINGWOOD",
            "state": "NJ",
            "postal_code": "07456",
            "telephone_number": "973-839-3434",
            "fax_number": "973-839-1366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 SKYLINE LAKES DR",
            "address_2": "STE #8",
            "city": "RINGWOOD",
            "state": "NJ",
            "postal_code": "07456",
            "telephone_number": "973-839-3434",
            "fax_number": "973-839-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPSA",
        "first_name": "RADU",
        "middle_name": "MYRON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22D101896100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MYRON",
            "last_name": "LUPSA",
            "middle_name": "RADU",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Providers in Ringwood, NJ by specialty
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• 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.