Individual provider Active NPI

Michael Henry Hogan, DDS

  • Dentist
  • Union, NJ
National Provider Identifier
1588810253
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DI023881 Issued in NJ
Practice address
2333 Morris Ave Ste A111
Union, NJ 07083-5737
Phone
(908) 687-7036
Fax
(908) 687-5215
NPI assigned
Aug 14, 2008
Last updated
Nov 18, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 055343 NY
Dentist 122300000X DI023881 NJ Primary

Addresses

Primary practice location

2333 Morris Ave Ste A111
Union, NJ 07083-5737

Mailing address

2333 Morris Ave Ste A111
Union, NJ 07083-5737
Phone (908) 687-7036

Other identifiers 1

IdentifierTypeStateIssuer
03343693MedicaidNY

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151002001334 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6507174018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI023881NJMDDentist
055343NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Union Family Dental Dentist CurrentSince Nov 20, 2022 Accepting new patients

Locations

2333 Morris Ave
Ste A111
Union, NJ 07083
Phone (908) 687-7036

2401 Morris Ave
Ste 205
Union, NJ 07083

Organizations & group practices 1

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": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1588810253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2333 MORRIS AVE STE A111",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835737",
            "telephone_number": "908-687-7036",
            "fax_number": "908-687-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2333 MORRIS AVE STE A111",
            "city": "UNION",
            "state": "NJ",
            "postal_code": "070835737",
            "telephone_number": "908-687-7036",
            "fax_number": "908-687-5215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOGAN",
        "first_name": "MICHAEL",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-14",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "055343",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI023881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03343693",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, NJ

Sources for this page

Verify at the official NPI Registry.