Individual provider Active NPI

Tawana M. Medlin, D.D.S

  • General Practice Dentistry
  • Berlin, NJ
National Provider Identifier
1730300039
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02944300 Issued in NJ
Practice address
19 Harker Ave
Berlin, NJ 08009-2331
Phone
(856) 768-3332
NPI assigned
May 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI02944300 NJ Primary
Dentist 122300000X G1-0001168 DE

Addresses

Primary practice location

19 Harker Ave
Berlin, NJ 08009-2331

Mailing address

19 Harker Ave
Berlin, NJ 08009-2331
Phone (856) 768-3332

Other practice location 1

200 Continental Dr Ste 401
Newark, DE 19713-4337
Phone (302) 222-6269

Other practice location 2

102 Sleepy Hollow Dr Ste 100
Middletown, DE 19709-5841
Phone (302) 378-3384

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
G1-0001168DEMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1730300039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 HARKER AVE",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080092331",
            "telephone_number": "856-768-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 HARKER AVE",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080092331",
            "telephone_number": "856-768-3332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Continental Dr Ste 401",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "DE",
            "postal_code": "197134337",
            "country_code": "US",
            "telephone_number": "302-222-6269",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "102 Sleepy Hollow Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "DE",
            "postal_code": "197095841",
            "country_code": "US",
            "telephone_number": "302-378-3384",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDLIN",
        "first_name": "TAWANA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02944300",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DE",
            "license": "G1-0001168",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.