Mark A Vitale, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

22DI014141 Issued in NJ

Practice address

69 State Highwy 27
Edison, NJ 08820

Phone

(732) 494-7575

Fax

(732) 494-4105

NPI assigned

Aug 22, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Mark a Vitale DMD & Paul M Tedeschi DMD PA

  • Dentist
  • Edison, NJ
  • NPI 1558306415
  Authorized official Same address or phone

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700992526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 STATE HIGHWY 27",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "08820",
            "telephone_number": "732-494-7575",
            "fax_number": "732-494-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 STATE HIGHWY 27",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "08820",
            "telephone_number": "732-494-7575",
            "fax_number": "732-494-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITALE",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI014141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sowmya Vishnubhakthula
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• Vitaequip LLC
• Vital Decisions LLC
• Vanessa Vitullo
• Virgil Vives, DDS
• Kashfia Vohra, D.D.S.
• Pauline Volfinzon
• Olivia Kate Volpe

• Dentist in Edison, NJ
• Providers in Edison, NJ by specialty
• Dentist in New Jersey

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.