Active NPI
Mark Henin
- Dentist
- West Long Branch, NJ
National Provider Identifier
1588300016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22D102976600
- Practice address
- 67 NJ-36
West Long Branch, NJ 07764 - Phone
- (732) 771-7734
- NPI assigned
- May 8, 2022
- Last updated
- Aug 2, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 22D102976600 | NJ | Primary |
| Student in an Organized Health Care Education/Training Program | 390200000X | NU |
Addresses
Primary practice location
67 NJ-36
West Long Branch, NJ 07764
Mailing address
10 Whittier Dr
Manalapan, NJ 07726-3720
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22D102976600 | NJ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1651968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722556800000",
"number": "1588300016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 WHITTIER DR",
"city": "MANALAPAN",
"state": "NJ",
"postal_code": "077263720"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "67 NJ-36",
"city": "WEST LONG BRANCH",
"state": "NJ",
"postal_code": "07764",
"telephone_number": "732-771-7734"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENIN",
"first_name": "MARK",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-05-08",
"last_updated": "2024-08-02",
"certification_date": "2024-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22D102976600",
"primary": true
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Long Branch, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.