Daniel Kubikian, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

22D02270601 Issued in NJ

Practice address

340 Egg Harbor Rd
Sewell, NJ 08080-2322

Phone

(856) 256-7778

Fax

(856) 256-7702

NPI assigned

Jun 1, 2007

Last updated

Feb 21, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• South Jersey Periodontics & Dental Implants, LLC

  • Periodontics
  • Sewell, NJ
  • NPI 1730925173
  NPD Authorized official

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

{
    "created_epoch": "1180656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1619179702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 EGG HARBOR RD",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080801856",
            "telephone_number": "856-256-7778",
            "fax_number": "856-256-7702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 EGG HARBOR RD",
            "city": "SEWELL",
            "state": "NJ",
            "postal_code": "080802322",
            "telephone_number": "856-256-7778",
            "fax_number": "856-256-7702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBIKIAN",
        "first_name": "DANIEL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-01",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "PA",
            "license": "DS035257",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22D02270601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jodi Lynn Koutsovitis
• David Joseph Kovalsky, DO
• Abigail Leigh Kratt, PT, DPT, OCS, SCS
• Karen S Krieg, DO
• Alexandra Krouse
• Cody John Kulik, PT, DPT
• Madyllen Ling Kung, DMD
• Ryan Kunzler, PT, DPT
• Audrey Lynn Kurtz, DPT
• Erich Kurtz, DPT

• Periodontics in Sewell, NJ
• Providers in Sewell, NJ by specialty
• Periodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.