Organization Active NPI

Cumberland Periodontal Associates, P.a.

  • Dentist
  • Vineland, NJ
National Provider Identifier
1518115377
Registry record updated Sep 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
NJ11102 Issued in NJ
Legal business name
CUMBERLAND PERIODONTAL ASSOCIATES, P.A.
Practice address
1077 E. Chestnut Ave.
Vineland, NJ 08360
Phone
(856) 696-3990
Fax
(856) 696-2121
NPI assigned
Sep 5, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2008

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

Authorized official

Name
Dr. Marc David Stein, D.D.S.
Title
Owner
Phone
(856) 696-3990

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X NJ11102 NJ Primary
PeriodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0300X 2068 NJ

Addresses

Primary practice location

1077 E. Chestnut Ave.
Vineland, NJ 08360

Mailing address

1077 E. Chestnut Ave.
Vineland, NJ 08360
Phone (856) 696-3990

National Provider Directory

National Provider Directory

Locations

1077 E Chestnut Ave
Vineland, NJ 08360
Phone (856) 696-2299

17 W Red Bank Ave
Ste 104
Woodbury, NJ 08096
Phone (856) 848-0665

NPI Registry JSON

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220572800000",
    "number": "1518115377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1077 E. CHESTNUT AVE.",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "08360",
            "telephone_number": "856-696-3990",
            "fax_number": "856-696-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1077 E. CHESTNUT AVE.",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "08360",
            "telephone_number": "856-696-3990",
            "fax_number": "856-696-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUMBERLAND PERIODONTAL ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-05",
        "last_updated": "2008-09-05",
        "status": "A",
        "authorized_official_last_name": "STEIN",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "856-696-3990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "NJ11102",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "2068",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineland, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.