NPIMap

Organization Active NPI

Daniel J. Dejianne DC

  • Chiropractor
  • Brick, NJ
National Provider Identifier
1700065737
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38MC00195700 Issued in NJ
Legal business name
DANIEL J. DEJIANNE DC
Practice address
1800 Lanes Mill Rd
Brick, NJ 08724-5204
Phone
(732) 458-0800
Fax
(732) 458-5809
NPI assigned
Oct 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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

Authorized official

Name
Dr. Daniel J. Dejianne, DCNPI 1851461172
Title
Owner
Phone
(732) 458-0800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 38MC00195700 NJ Primary

Addresses

Primary practice location

1800 Lanes Mill Rd
Brick, NJ 08724-5204

Mailing address

1800 Lanes Mill Rd
Brick, NJ 08724-5204
Phone (732) 458-0800

Other identifiers 1

IdentifierTypeStateIssuer
1142909MedicaidNJ

Other names 1

  • Herbertsville Chiropractic Center Doing business as

National Provider Directory

National Provider Directory

Locations

1800 Lanes Mill Rd
Brick, NJ 08724
Phone (732) 458-0800

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193356800000",
    "number": "1700065737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 LANES MILL RD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087245204",
            "telephone_number": "732-458-0800",
            "fax_number": "732-458-5809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 LANES MILL RD",
            "city": "BRICK",
            "state": "NJ",
            "postal_code": "087245204",
            "telephone_number": "732-458-0800",
            "fax_number": "732-458-5809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANIEL J. DEJIANNE DC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-26",
        "last_updated": "2007-10-26",
        "status": "A",
        "authorized_official_last_name": "DEJIANNE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "732-458-0800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00195700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1142909",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Herbertsville Chiropractic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.