Rosanne V Mirakian, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2261900 Issued in NJ

Practice address

600 Pemberton Browns Mills Road
Pemberton, NJ 08060

Phone

(609) 894-1213

Fax

(609) 894-1219

NPI assigned

Jul 31, 2006

Last updated

Nov 30, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

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

State licenses

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448841600000",
    "number": "1669488730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52225",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191157225",
            "telephone_number": "215-880-5135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 PEMBERTON BROWNS MILLS ROAD",
            "city": "PEMBERTON",
            "state": "NJ",
            "postal_code": "08060",
            "telephone_number": "609-894-1213",
            "fax_number": "609-894-1219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRAKIAN",
        "first_name": "ROSANNE",
        "middle_name": "V",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2015-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "2261900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0099490",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Candace Lenore McDade, M.S., RBT
• Courtney McLaren
• Merakey New Jersey
• Jaclyn S Merrill, RBT
• Ellen Christine Miller, COTA
• Orin H Morrison Jr., CADC
• Casey Moss
• Kylee Niroda, RBT
• Sophia Nugent
• Chiamaka M Odikpo, RBT

• General Practice Dentistry in Pemberton, NJ
• Providers in Pemberton, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2015; 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.