Active NPI
Mark L Radler, DMD
- Pediatric Dentistry
- Long Branch, NJ
National Provider Identifier
1700877800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DI00841301
- Practice address
- 300 2ND Ave
Monmouth Medical Center
Long Branch, NJ 07740 - Phone
- (732) 923-6585
- Fax
- (732) 923-6588
- NPI assigned
- Oct 30, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DI00841301 | NJ | Primary |
Addresses
Primary practice location
300 2ND Ave
Monmouth Medical Center
Long Branch, NJ 07740
Mailing address
209 Marshall Lane
Carrollton, VA 23314
Phone (732) 890-3380
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851608 | Medicaid | NJ |
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 |
|---|---|---|---|
| DI00841301 | NJ | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212364800000",
"number": "1700877800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 MARSHALL LANE",
"city": "CARROLLTON",
"state": "VA",
"postal_code": "23314",
"telephone_number": "732-890-3380",
"fax_number": "757-238-2365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 2ND AVE",
"address_2": "MONMOUTH MEDICAL CENTER",
"city": "LONG BRANCH",
"state": "NJ",
"postal_code": "07740",
"telephone_number": "732-923-6585",
"fax_number": "732-923-6588"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RADLER",
"first_name": "MARK",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-30",
"last_updated": "2008-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NJ",
"license": "DI00841301",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1851608",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Long Branch, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 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.