Individual provider Active NPI

Frederick James Carbone, D.D.S.

  • Dentist
  • Roseland, NJ
National Provider Identifier
1619986783
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
NJDI0014093 Issued in NJ
Practice address
157 Eagle Rock Ave
Roseland, NJ 07068-1353
Phone
(973) 228-0039
NPI assigned
Aug 6, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NJDI0014093 NJ Primary

Addresses

Primary practice location

157 Eagle Rock Ave
Roseland, NJ 07068-1353

Mailing address

157 Eagle Rock Ave
Roseland, NJ 07068-1353
Phone (973) 228-0039

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
I20150722003855 NJ Order and Referring Only - DentistPractitioner - Dentist 9436462256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
NJDI0014093NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1154822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619986783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 EAGLE ROCK AVE",
            "city": "ROSELAND",
            "state": "NJ",
            "postal_code": "070681353",
            "telephone_number": "973-228-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 EAGLE ROCK AVE",
            "city": "ROSELAND",
            "state": "NJ",
            "postal_code": "070681353",
            "telephone_number": "973-228-0039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBONE",
        "first_name": "FREDERICK",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "NJDI0014093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseland, NJ

Sources for this page

Verify at the official NPI Registry.