Active NPI
Patrick William Dinicola, DMD
- Dentist
- Wayne, NJ
National Provider Identifier
1497804132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22DI02203200
- Practice address
- 330 Ratzer Rd
Wayne, NJ 07470-7702 - Phone
- (973) 696-6002
- Fax
- (973) 696-6008
- NPI assigned
- Jan 10, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 22DI02203200 | NJ | Primary |
Addresses
Primary practice location
330 Ratzer Rd
Wayne, NJ 07470-7702
Mailing address
466 Laurel LN
Kinnelon, NJ 07405-3122
Phone (973) 838-3872
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02203200 | NJ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497804132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "466 LAUREL LN",
"city": "KINNELON",
"state": "NJ",
"postal_code": "074053122",
"telephone_number": "973-838-3872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 RATZER RD",
"city": "WAYNE",
"state": "NJ",
"postal_code": "074707702",
"telephone_number": "973-696-6002",
"fax_number": "973-696-6008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DINICOLA",
"first_name": "PATRICK",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22DI02203200",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wayne, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.