Individual provider Active NPI

Michael C Erlichman, D.D.S.

  • Oral and Maxillofacial Surgery (Dentist)
  • Paterson, NJ
National Provider Identifier
1730182403
Registry record updated Jan 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
10278 Issued in NJ
Practice address
703 Main Street
St. Joseph's Regional Medical Center
Paterson, NJ 07503
Phone
(973) 754-2050
Fax
(973) 754-2633
NPI assigned
May 24, 2005
Last updated
Jan 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 10278 NJ Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 30470 NY

Addresses

Primary practice location

703 Main Street
St. Joseph's Regional Medical Center
Paterson, NJ 07503

Mailing address

31 Rolling Views Drive
Woodland Park, NJ 07424
Phone (973) 754-2050

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170918000079 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5890989610

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10278NJMDOral and Maxillofacial Surgery (Dentist)
30470NYMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Regional Center for Oral & Maxillofacial Surgery Oral and Maxillofacial Surgery PastSince Aug 2, 1995 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421193600000",
    "number": "1730182403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 ROLLING VIEWS DRIVE",
            "city": "WOODLAND PARK",
            "state": "NJ",
            "postal_code": "07424",
            "telephone_number": "973-754-2050",
            "fax_number": "973-754-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "703 MAIN STREET",
            "address_2": "ST. JOSEPH'S REGIONAL MEDICAL CENTER",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "07503",
            "telephone_number": "973-754-2050",
            "fax_number": "973-754-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERLICHMAN",
        "first_name": "MICHAEL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2015-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "10278",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "30470",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paterson, NJ

Sources for this page

Verify at the official NPI Registry.