Individual provider Active NPI

Linda A Marroccoli, D.M.D.

  • Dentist
  • Colts Neck, NJ
National Provider Identifier
1609108323
Registry record updated Feb 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI01624100 Issued in NJ
Practice address
8 Wyndcrest CT
Colts Neck, NJ 07722-1277
Phone
(732) 946-0757
NPI assigned
Feb 5, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI01624100 NJ Primary

Addresses

Primary practice location

8 Wyndcrest CT
Colts Neck, NJ 07722-1277

Mailing address

8 Wyndcrest CT
Colts Neck, NJ 07722-1277
Phone (732) 946-0757

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
I20170601001821 NJ Order and Referring Only - DentistPractitioner - Dentist 0446527089

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI01624100NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1265328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265328000000",
    "number": "1609108323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 WYNDCREST CT",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "077221277",
            "telephone_number": "732-946-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 WYNDCREST CT",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "077221277",
            "telephone_number": "732-946-0757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARROCCOLI",
        "first_name": "LINDA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-05",
        "last_updated": "2010-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI01624100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colts Neck, NJ

Sources for this page

Verify at the official NPI Registry.