Individual provider Active NPI

Andre P. Huwyler, D.M.D.

  • General Practice Dentistry
  • Montclair, NJ
National Provider Identifier
1508951948
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DI14048 Issued in NJ
Practice address
73 Park St.
Montclair, NJ 07042
Phone
(973) 783-1500
Fax
(973) 783-1503
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

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 DI14048 NJ Primary

Addresses

Primary practice location

73 Park St.
Montclair, NJ 07042

Mailing address

4 Kings Ridge Rd.
Randolph, NJ 07869
Phone (973) 584-3156

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
I20150507002189 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9436478799

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI14048NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508951948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 KINGS RIDGE RD.",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "07869",
            "telephone_number": "973-584-3156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73 PARK ST.",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "07042",
            "telephone_number": "973-783-1500",
            "fax_number": "973-783-1503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUWYLER",
        "first_name": "ANDRE",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI14048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

Verify at the official NPI Registry.