Individual provider Active NPI

Lauren Psillos-Maldonado, DMD

  • General Practice Dentistry
  • Hillsborough, NJ
National Provider Identifier
1699980433
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19465 Issued in NJ
Practice address
419 US Highway 206
Hillsborough, NJ 08844-5094
Phone
(908) 874-4555
Fax
(908) 281-9560
NPI assigned
May 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 19465 NJ Primary

Addresses

Primary practice location

419 US Highway 206
Hillsborough, NJ 08844-5094

Mailing address

419 Route 206
Hillsborough, NJ 08844-5094
Phone (908) 874-4555

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150618000165 NJ Order and Referring Only - DentistPractitioner - Dentist 1052622008

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19465NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Towne Centre Family Dental General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699980433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "419 ROUTE 206",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088445094",
            "telephone_number": "908-874-4555",
            "fax_number": "908-281-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419 US HIGHWAY 206",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088445094",
            "telephone_number": "908-874-4555",
            "fax_number": "908-281-9560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PSILLOS-MALDONADO",
        "first_name": "LAUREN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "19465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsborough, NJ

Sources for this page

Verify at the official NPI Registry.