Individual provider Active NPI

Jonathan A Glatt, DMD

  • Dentist
  • Lakewood, NJ
National Provider Identifier
1518041920
Registry record updated Nov 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DI02119300 Issued in NJ
Practice address
838 River Ave
Suite 1
Lakewood, NJ 08701-5279
Phone
(732) 363-4477
Fax
(732) 905-7085
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DI02119300 NJ Primary

Addresses

Primary practice location

838 River Ave
Suite 1
Lakewood, NJ 08701-5279

Mailing address

838 River Ave
Suite 1
Lakewood, NJ 08701-5279
Phone (732) 363-4477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20191001000225 PA Order and Referring Only - DentistPractitioner - Dentist 9638409949

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI02119300NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Dental Associates, LLC Dentist PastSince Oct 27, 2019 Accepting new patients
Joseph a. Oleske III, DDS, P.C. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289952000000",
    "number": "1518041920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "838 RIVER AVE",
            "address_2": "SUITE 1",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015279",
            "telephone_number": "732-363-4477",
            "fax_number": "732-905-7085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "838 RIVER AVE",
            "address_2": "SUITE 1",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087015279",
            "telephone_number": "732-363-4477",
            "fax_number": "732-905-7085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLATT",
        "first_name": "JONATHAN",
        "middle_name": "A",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2010-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI02119300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

Verify at the official NPI Registry.