Brenda Nathan, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

22DI01862600 Issued in NJ

Practice address

901 Dehirsch Avenue
Woodbine, NJ 08270

Phone

(609) 861-2784

Fax

(609) 861-3160

NPI assigned

Nov 19, 2007

Sex

Female

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

Practice roles

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.

• Woodbine Dental PA

  • Dentist
  • Woodbine, NJ
  • NPI 1700919594
  NPD (past)

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

{
    "created_epoch": "1195430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195430400000",
    "number": "1710168778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 516",
            "address_2": "901 DEHIRSCH AVENUE",
            "city": "WOODBINE",
            "state": "NJ",
            "postal_code": "08270",
            "telephone_number": "609-861-2784",
            "fax_number": "609-861-3160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 DEHIRSCH AVENUE",
            "city": "WOODBINE",
            "state": "NJ",
            "postal_code": "08270",
            "telephone_number": "609-861-2784",
            "fax_number": "609-861-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATHAN",
        "first_name": "BRENDA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-19",
        "last_updated": "2007-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI01862600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Kreckel
• Maurice Xuan Levan, M.D.
• David Timothy London, PH.D.
• John Francis McGrail, M.D.
• Med-Trans Corporation
• Jacques Nathan, DDS
• Partners Pharmacy LLC
• Christine Marie Picard, BSN, RN
• PPS of NJ LLC
• Olivia Prickett

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.