NPIMap

Organization Active NPI

Dr Michael J Cisar, DMD & Dr William L Derrickson, DMD, LLC

  • Dentist
  • Tinton Falls, NJ
National Provider Identifier
1689885345
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DI21287 Issued in NJ
Legal business name
DR MICHAEL J CISAR, DMD & DR WILLIAM L DERRICKSON, DMD, LLC
Practice address
709 Sycamore Ave
Tinton Falls, NJ 07701-4946
Phone
(732) 842-6300
Fax
(732) 842-3467
NPI assigned
May 24, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael J CisarNPI 1831269372
Title
Dentist
Phone
(732) 842-6300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 122300000X DI21287 NJ Primary

Addresses

Primary practice location

709 Sycamore Ave
Tinton Falls, NJ 07701-4946

Mailing address

709 Sycamore Ave
Tinton Falls, NJ 07701-4946
Phone (732) 842-6300

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689885345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 SYCAMORE AVE",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014946",
            "telephone_number": "732-842-6300",
            "fax_number": "732-842-3467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 SYCAMORE AVE",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014946",
            "telephone_number": "732-842-6300",
            "fax_number": "732-842-3467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR MICHAEL J CISAR, DMD & DR WILLIAM L DERRICKSON, DMD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CISAR",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "732-842-6300",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI21287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinton Falls, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.