Justin Charles Ponquinette, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

22DI02369900 Issued in NJ

Practice address

970 Clifton Ave
Second Floor
Clifton, NJ 07013-2731

Phone

(973) 473-3100

NPI assigned

Apr 15, 2008

Last updated

Apr 15, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208217600000",
    "number": "1679747190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 DEEPWATER CIR",
            "city": "MANALAPAN",
            "state": "NJ",
            "postal_code": "077264148",
            "telephone_number": "718-704-3037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 CLIFTON AVE",
            "address_2": "SECOND FLOOR",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132731",
            "telephone_number": "973-473-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PONQUINETTE",
        "first_name": "JUSTIN",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI02369900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diana Alexandra Polania, APN
• Poller Dental Group
• Enrique Polo Molina, OPAC
• Katherine Delaney Polos, M.S.,CCC-SLP
• Shira Pomrantz, LCSW
• Maria Lauren Pontoriero, DPT
• Michael A Pontoriero, M.D.
• Chiu-Man Poon, MD
• Cornelio Porras
• Joseph Porter, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Clifton, NJ
• Providers in Clifton, NJ by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.