Individual provider Active NPI

Eric Weiss, DMD

  • Periodontics
  • Livingston, NJ
National Provider Identifier
1730238668
Registry record updated Aug 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
22DI01807200 Issued in NJ
Practice address
340 E Northfield Rd
Suite #2a
Livingston, NJ 07039-4892
Phone
(973) 992-8600
Fax
(973) 992-8626
NPI assigned
Jan 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 22DI01807200 NJ Primary

Addresses

Primary practice location

340 E Northfield Rd
Suite #2a
Livingston, NJ 07039-4892

Mailing address

340 E Northfield Rd
Suite #2a
Livingston, NJ 07039-4892
Phone (973) 992-8600

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
I20160517000306 NJ Order and Referring Only - DentistPractitioner - Dentist 0840589743

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Livingston Periodontal Associates, LLC Periodontics Current Accepting new patients
Vanguard Periodontal & Implant Associates, LLC Periodontics Current Accepting new patients

Locations

340 E Northfield Rd
Ste 2A
Livingston, NJ 07039
Phone (973) 992-8600

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439769600000",
    "number": "1730238668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 E NORTHFIELD RD",
            "address_2": "SUITE #2A",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394892",
            "telephone_number": "973-992-8600",
            "fax_number": "973-992-8626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 E NORTHFIELD RD",
            "address_2": "SUITE #2A",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070394892",
            "telephone_number": "973-992-8600",
            "fax_number": "973-992-8626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEISS",
        "first_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-09",
        "last_updated": "2015-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22DI01807200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, NJ

Sources for this page

Verify at the official NPI Registry.