Individual provider Active NPI

Marcus Leibowitz, DMD

  • Dentist
  • Sewell, NJ
National Provider Identifier
1568020618
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02785400 Issued in NJ
Practice address
141 Tuckahoe Rd Ste 380
Sewell, NJ 08080-3845
Phone
(856) 878-2330
NPI assigned
Jun 4, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 22DI02785400 NJ Primary

Addresses

Primary practice location

141 Tuckahoe Rd Ste 380
Sewell, NJ 08080-3845

Mailing address

141 Tuckahoe Rd Ste 380
Sewell, NJ 08080-3845
Phone (856) 878-2330

Other practice location 1

1000 Atlantic Ave
Camden, NJ 08104-1132
Phone (856) 246-3545

Other practice location 2

19 High Ridge Rd
Ocean, NJ 07712-3460
Phone (732) 403-4752

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

LicenseStateTypeSpecialty
22DI02785400NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1568020618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 TUCKAHOE RD STE 380",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080803845",
            "telephone_number": "856-878-2330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 TUCKAHOE RD STE 380",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080803845",
            "telephone_number": "856-878-2330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Atlantic Ave",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "NJ",
            "postal_code": "081041132",
            "country_code": "US",
            "telephone_number": "856-246-3545",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19 High Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Ocean",
            "state": "NJ",
            "postal_code": "077123460",
            "country_code": "US",
            "telephone_number": "732-403-4752",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEIBOWITZ",
        "first_name": "MARCUS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-04",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02785400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sewell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; 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.