Individual provider Active NPI

Eden Seitomer, DMD

  • General Practice Dentistry
  • Linwood, NJ
National Provider Identifier
1598052482
Registry record updated Oct 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02495000 Issued in NJ
Practice address
214 New Road
Linwood, NJ 08221-1214
Phone
(609) 653-0980
NPI assigned
Jun 30, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI02495000 NJ Primary

Addresses

Primary practice location

214 New Road
Linwood, NJ 08221-1214

Mailing address

214 New Rd
Linwood, NJ 08221-1214
Phone (609) 653-0980

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
I20150428000948 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1052630910

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02495000NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Linwood LV Dental, LLC General Practice CurrentSince Aug 27, 2023 Accepting new patients
Eden Family Dental LLC Current Accepting new patients

Locations

214 New Rd
Linwood, NJ 08221
Phone (609) 653-0980

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571443200000",
    "number": "1598052482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 NEW RD",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211214",
            "telephone_number": "609-653-0980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 NEW ROAD",
            "city": "LINWOOD",
            "state": "NJ",
            "postal_code": "082211214",
            "telephone_number": "609-653-0980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEITOMER",
        "first_name": "EDEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-30",
        "last_updated": "2019-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02495000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Linwood, NJ

Sources for this page

Verify at the official NPI Registry.