Richard Neil Tennenbaum, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

10192 Issued in NJ

Practice address

474 Hurffville Crosskeys Rd
Ste C
Sewell, NJ 08080-2321

Phone

(856) 589-7900

Fax

(856) 582-4686

NPI assigned

Jun 21, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Riverwalk Family Dental LLC

  • Dentist
  • Haddon Township, NJ
  • NPI 1659954915
  NPD (past)

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1528064037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 HURFFVILLE-CROSS KEYS ROAD",
            "address_2": "SUITE C",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802319",
            "telephone_number": "856-589-7900",
            "fax_number": "856-582-4686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 HURFFVILLE CROSSKEYS RD",
            "address_2": "STE C",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802321",
            "telephone_number": "856-589-7900",
            "fax_number": "856-582-4686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNENBAUM",
        "first_name": "RICHARD",
        "middle_name": "NEIL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "10192",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2901404",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michele Tartaglia, D.O.
• Shari Tartaglia
• Gabriela Taslitsky
• Lauryn Alexis Taylor, BCBA
• Temple University of the Commonwealth System of Higher Education
• Terraces Alf LLC
• Terraces at Parke Place
• Alyson Catherine Terranova, PT, DPT
• Alexis Testa
• Carrie Teyssier, AGPCNP-BC

• Oral and Maxillofacial Surgery (Dentist) in Sewell, NJ
• Providers in Sewell, NJ by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.

Verify at the official NPI Registry.