Individual provider Active NPI

Michael R Merkowsky, DMD

  • General Practice Dentistry
  • Marlton, NJ
National Provider Identifier
1659419554
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13632 Issued in NJ
Practice address
55 E Route 70
Suite 1
Marlton, NJ 08053-1769
Phone
(856) 983-4448
Fax
(856) 983-4546
NPI assigned
Feb 2, 2007
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
General Practice Dentistry 1223G0001X 13632 NJ Primary

Addresses

Primary practice location

55 E Route 70
Suite 1
Marlton, NJ 08053-1769

Mailing address

55 E Route 70
Suite 1
Marlton, NJ 08053-1769
Phone (856) 983-4448

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
I20150420001425 NJ Order and Referring Only - DentistPractitioner - Dentist 9234457425

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13632NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659419554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E ROUTE 70",
            "address_2": "SUITE 1",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531769",
            "telephone_number": "856-983-4448",
            "fax_number": "856-983-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 E ROUTE 70",
            "address_2": "SUITE 1",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080531769",
            "telephone_number": "856-983-4448",
            "fax_number": "856-983-4546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERKOWSKY",
        "first_name": "MICHAEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "13632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlton, NJ

Sources for this page

Verify at the official NPI Registry.