Mitchell Jeffrey Gardiner, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

NJ12455 Issued in NJ

Practice address

59 Avenue at the Common
Suite 205
Shrewsbury, NJ 07702

Phone

(732) 741-5533

Fax

(732) 741-6064

NPI assigned

Jan 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• DRS. Gardiner & Dituri, PA

  • Dental Clinic/Center
  • Shrewsbury, NJ
  • NPI 1407013188
  NPD (past) Authorized official

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1598816365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 AVENUE AT THE COMMON",
            "address_2": "SUITE 205",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "07702",
            "telephone_number": "732-741-5533",
            "fax_number": "732-741-6064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 AVENUE AT THE COMMON",
            "address_2": "SUITE 205",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "07702",
            "telephone_number": "732-741-5533",
            "fax_number": "732-741-6064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDINER",
        "first_name": "MITCHELL",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "NJ12455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peggy A Ford, MS, PT
• Giana Galasso
• Stephanie Lynn Gallant-Goedtel, FNP
• Elsie Lucia Ricardos Garcia-Faria, P.T.
• Garden State Retina Associates LLC
• Stephanie Isabel Garley, PA-C
• Julie Garofalo
• Deanna Gebele, DPT
• Bryan Jeremy Gelfand, DDS
• Marosa Geroso, CRNA

• General Practice Dentistry in Shrewsbury, NJ
• Providers in Shrewsbury, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.