Individual provider Active NPI

Laurence Craig Breiterman, D.M.D.

  • General Practice Dentistry
  • Wayne, NJ
National Provider Identifier
1669452132
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17559 Issued in NJ
Practice address
1211 Hamburg Tpke
Suite 305
Wayne, NJ 07470-5043
Phone
(973) 694-2835
Fax
(973) 694-8515
NPI assigned
Jan 19, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 17559 NJ Primary

Addresses

Primary practice location

1211 Hamburg Tpke
Suite 305
Wayne, NJ 07470-5043

Mailing address

1211 Hamburg Tpke
Suite 305
Wayne, NJ 07470-5043
Phone (973) 694-2835

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
17559NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1669452132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 HAMBURG TPKE",
            "address_2": "SUITE 305",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074705043",
            "telephone_number": "973-694-2835",
            "fax_number": "973-694-8515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 HAMBURG TPKE",
            "address_2": "SUITE 305",
            "city": "WAYNE",
            "state": "NJ",
            "postal_code": "074705043",
            "telephone_number": "973-694-2835",
            "fax_number": "973-694-8515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREITERMAN",
        "first_name": "LAURENCE",
        "middle_name": "CRAIG",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "17559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.