Edward Jay Smith, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DI14801 Issued in NJ

Practice address

2 W Hanover Ave
Suite 201
Randolph, NJ 07869-4222

Phone

(973) 895-5111

Fax

(973) 895-5142

NPI assigned

Feb 28, 2007

Sex

Male

Sole proprietor

Yes

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

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.

• GD NJ Randolph LLC

  • General Practice Dentistry
  • Randolph, NJ
  • NPI 1003689233
  NPD (past)

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720116296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 W HANOVER AVE",
            "address_2": "SUITE 201",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078694222",
            "telephone_number": "973-895-5111",
            "fax_number": "973-895-5142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 W HANOVER AVE",
            "address_2": "SUITE 201",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "078694222",
            "telephone_number": "973-895-5111",
            "fax_number": "973-895-5142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "EDWARD",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI14801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David J Simon
• Michael David Singer, DMD
• Vileen Singh
• Robert Raymond Siroty, M.D.
• Skylands Center Offering Autism Programs, Inc.
• Kaitlyn Smith
• Marilyn Soberano IV, HEMODIALYSIS RN.
• Theresa Sokolowski, O.D.
• Marissa Sosin, CCC-SLP
• Duane G. Sossong, D.O.

• Dentist in Randolph, NJ
• Providers in Randolph, 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.