Individual provider Active NPI

Mark Sandler, DDS

  • Dentist
  • Pennsauken, NJ
National Provider Identifier
1649492810
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI01023800 Issued in NJ
Practice address
5015 Westfield Ave
Pennsauken, NJ 08110-2953
Phone
(856) 665-6050
Fax
(856) 665-3637
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
No

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 22DI01023800 NJ Primary

Addresses

Primary practice location

5015 Westfield Ave
Pennsauken, NJ 08110-2953

Mailing address

5015 Westfield Ave
Pennsauken, NJ 08110-2953
Phone (856) 665-6050

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
I20150514001798 NJ Order and Referring Only - DentistPractitioner - Dentist 5799005708

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI01023800NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649492810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5015 WESTFIELD AVE",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "081102953",
            "telephone_number": "856-665-6050",
            "fax_number": "856-665-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5015 WESTFIELD AVE",
            "city": "PENNSAUKEN",
            "state": "NJ",
            "postal_code": "081102953",
            "telephone_number": "856-665-6050",
            "fax_number": "856-665-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDLER",
        "first_name": "MARK",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI01023800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pennsauken, NJ

Sources for this page

Verify at the official NPI Registry.