Active NPI
Rudolph R Leidl, DMD
- General Practice Dentistry
- Califon, NJ
National Provider Identifier
1669541934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22DI01106300
- Practice address
- 87 W Valley Brook Rd
Califon, NJ 07830-3529 - Phone
- (908) 876-9772
- NPI assigned
- Nov 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22DI01106300 | NJ | Primary |
Addresses
Primary practice location
87 W Valley Brook Rd
Califon, NJ 07830-3529
Mailing address
87 W Valley Brook Rd
Califon, NJ 07830-3529
Phone (908) 876-9772
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI01106300 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1422921600000",
"number": "1669541934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "87 W VALLEY BROOK RD",
"city": "CALIFON",
"state": "NJ",
"postal_code": "078303529",
"telephone_number": "908-876-9772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "87 W VALLEY BROOK RD",
"city": "CALIFON",
"state": "NJ",
"postal_code": "078303529",
"telephone_number": "908-876-9772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEIDL",
"first_name": "RUDOLPH",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2015-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "22DI01106300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Califon, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.