Active NPI
Michelle T Respler Rubin, DMD
- Periodontics
- Newark, NJ
National Provider Identifier
1669633202
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 22DI02364100
- Practice address
- 110 Bergen St
Perio Dept. RM. C781
Newark, NJ 07103-2495 - Phone
- (973) 972-4214
- NPI assigned
- Jun 17, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 22DI02364100 | NJ | Primary |
Addresses
Primary practice location
110 Bergen St
Perio Dept. RM. C781
Newark, NJ 07103-2495
Mailing address
5 Annabelle Ave
Clifton, NJ 07012-1805
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02364100 | NJ | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213660800000",
"number": "1669633202",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 ANNABELLE AVE",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070121805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 BERGEN ST",
"address_2": "PERIO DEPT. RM. C781",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071032495",
"telephone_number": "973-972-4214"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RESPLER RUBIN",
"first_name": "MICHELLE",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-17",
"last_updated": "2008-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NJ",
"license": "22DI02364100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.