Individual provider Active NPI

David A Lederman, DMD

  • Oral and Maxillofacial Pathology Dentistry
  • Freehold, NJ
National Provider Identifier
1578587408
Registry record updated Aug 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
22FI00823501 Issued in NJ
Practice address
32 Cobblestone Way
Freehold, NJ 07728-7755
Phone
(732) 850-4995
Fax
(732) 866-8830
NPI assigned
Jul 26, 2006
Last updated
Aug 28, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 22FI00823501 NJ Primary

Addresses

Primary practice location

32 Cobblestone Way
Freehold, NJ 07728-7755

Mailing address

23 Fisher Island CT
Monroe, NJ 08831-8924
Phone (732) 850-4995

Other identifiers 1

IdentifierTypeStateIssuer
190008491OtherNJOXFORD

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060306000743 NJ Practitioner - Oral SurgeryPractitioner - Pathology 4082620869 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
79.08 of 100Reported as group
Quality
58.15
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22FI00823501NJMDOral and Maxillofacial Pathology Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
David a. Lederman, DMD, PA Oral and Maxillofacial Pathology CurrentSince Sep 1, 1997 Accepting new patients
Lakewood Pathology Associates, Inc. Current Accepting new patients
Emes Professional Associates, Inc. CurrentSince Jul 21, 2012 Accepting new patients
Center for Periodontal Health PastSince Sep 1, 1997 Accepting new patients
Ac Rao PC PastSince Feb 23, 2021 Accepting new patients

Locations

2905 Momentum Pl
Chicago, IL 60689

300 Columbus Cir
Ste A
Edison, NJ 08837
Phone (866) 909-7284

507 Stillwells Corner Rd
Freehold, NJ 07728
Phone (732) 462-8181

825 Rahway Ave
Union, NJ 07083
Phone (732) 901-7575

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440720000000",
    "number": "1578587408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 FISHER ISLAND CT",
            "city": "MONROE",
            "state": "NJ",
            "postal_code": "088318924",
            "telephone_number": "732-850-4995",
            "fax_number": "732-561-2270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 COBBLESTONE WAY",
            "city": "FREEHOLD",
            "state": "NJ",
            "postal_code": "077287755",
            "telephone_number": "732-850-4995",
            "fax_number": "732-866-8830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDERMAN",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2015-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "NJ",
            "license": "22FI00823501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "190008491",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freehold, NJ

Sources for this page

Verify at the official NPI Registry.