Daniel Weidberg, DMD
Individual provider Active NPI Dentist · Freehold, NJ
NPI 1659934735 · NPPES record last updated Aug 4, 2021
Key facts
- NPI
- 1659934735
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 22DI02821400 (NJ)
- Practice address
- 122 Professional View Dr BLDG 100
Freehold, NJ 07728-7902 - Phone
- (732) 625-8080
- NPI assigned
- Apr 15, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02821400 | NJ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tender Smiles 4 Kids of Monmouth, LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 22DI02821400 | NJ | Yes |
Addresses
Primary practice location
122 Professional View Dr BLDG 100
Freehold, NJ 07728-7902
Mailing address
122 Professional View Dr BLDG 100
Freehold, NJ 07728-7902
Phone (732) 625-8080
Other providers in Freehold, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.