Lucio Antonio Cardoso Jr., DDS, MD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

22DI02670600 Issued in NJ

Practice address

10 DRS James Parker Blvd Ste 101
Red Bank, NJ 07701-1500

Phone

(732) 426-0552

Fax

(732) 426-0553

NPI assigned

Jun 5, 2012

Last updated

Aug 27, 2024By the provider in NPPES

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

Credentials

Doctor of Medicine

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.

• Lacjr Facial Surgery, LLC

  dba Cardoso Cosmetic Center for Facial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Red Bank, NJ
  • NPI 1497532733
  NPD Authorized official

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1629339866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DRS JAMES PARKER BLVD STE 101",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011500",
            "telephone_number": "732-426-0552",
            "fax_number": "732-426-0553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 DRS JAMES PARKER BLVD STE 101",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077011500",
            "telephone_number": "732-426-0552",
            "fax_number": "732-426-0553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDOSO",
        "first_name": "LUCIO",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS, MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-05",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI02670600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Carangelo, BCBA
• David Theodore Carboy, MD
• Melissa A Card, BA PYSCH
• Cristianna Cardinale, OTD, OTR/L
• Jacqueline Cardona, LSW
• Care Core PT,LLC
• Ryan Carew
• Caring With Compassion
• Lori Ann Carlsen, LCSW
• Patricia E Carniglia, OD

• Oral and Maxillofacial Surgery (Dentist) in Red Bank, NJ
• Providers in Red Bank, NJ by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.