Philip M Echo, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

22DI01695900 Issued in NJ

Practice address

187 Washington Avenue, Suite 1 B
The Center for Oral & Maxillofacial Surgery & Implantol
Nutley, NJ 07110-1995

Phone

(973) 667-5844

Fax

(973) 667-6653

NPI assigned

May 17, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Oral & Maxillofacial Assoc of Nutley

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Nutley, NJ
  • NPI 1457417495
  NPD (past) Authorized official
• Oral and Maxillofacial Assoc of Nutley

  • Oral and Maxillofacial Surgery (Dentist)
  • Nutley, NJ
  • NPI 1811088701
  NPD (past) Authorized official
• Oral & Maxillofacial Associates of Montclair

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Montclair, NJ
  • NPI 1336298686

  Oral and Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1730396029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 WASHINGTON AVENUE, SUITE 1 B",
            "address_2": "THE CENTER FOR ORAL & MAXILLOFACIAL SURGERY & IMPLANTOL",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101995",
            "telephone_number": "973-667-5844",
            "fax_number": "973-667-6653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 WASHINGTON AVENUE, SUITE 1 B",
            "address_2": "THE CENTER FOR ORAL & MAXILLOFACIAL SURGERY & IMPLANTOL",
            "city": "NUTLEY",
            "state": "NJ",
            "postal_code": "071101995",
            "telephone_number": "973-667-5844",
            "fax_number": "973-667-6653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECHO",
        "first_name": "PHILIP",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "D1016959",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI01695900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lisa Endanattu, FNP-BC

• Oral and Maxillofacial Surgery (Dentist) in Nutley, NJ
• Providers in Nutley, NJ by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.