Active NPI
Richard Wayne Eytel, DMD
- Dentist
- West Orange, NJ
National Provider Identifier
1700925948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22D101083400
- Practice address
- 412 Pleasant Valley Way
Dentistry for Children
West Orange, NJ 07052 - Phone
- (973) 731-2468
- Fax
- (973) 731-2501
- NPI assigned
- Feb 5, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 22D101083400 | NJ | Primary |
Addresses
Primary practice location
412 Pleasant Valley Way
Dentistry for Children
West Orange, NJ 07052
Mailing address
412 Pleasant Valley Way
Dentistry for Children
West Orange, NJ 07052
Phone (973) 731-2468
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 |
|---|---|---|---|
| 22D101083400 | NJ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1700925948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "412 PLEASANT VALLEY WAY",
"address_2": "DENTISTRY FOR CHILDREN",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "07052",
"telephone_number": "973-731-2468",
"fax_number": "973-731-2501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "412 PLEASANT VALLEY WAY",
"address_2": "DENTISTRY FOR CHILDREN",
"city": "WEST ORANGE",
"state": "NJ",
"postal_code": "07052",
"telephone_number": "973-731-2468",
"fax_number": "973-731-2501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EYTEL",
"first_name": "RICHARD",
"middle_name": "WAYNE",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-02-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22D101083400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Orange, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.