Individual provider Active NPI

Craig Stanley Hirschberg, D.D.S.

  • Endodontics
  • Bayonne, NJ
National Provider Identifier
1740320555
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DI103097 Issued in NJ
Practice address
1173 Kennedy Blvd
Bayonne, NJ 07002-3132
Phone
(201) 339-1177
NPI assigned
Feb 8, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DI103097 NJ Primary

Addresses

Primary practice location

1173 Kennedy Blvd
Bayonne, NJ 07002-3132

Mailing address

365 Forest Rd
South Orange, NJ 07079-1632
Phone (973) 763-8175

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
I20151026000716 NJ Order and Referring Only - DentistPractitioner - Dentist 8325357767

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI103097NJMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Gwen Giannina DDS, LLC Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740320555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 FOREST RD",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070791632",
            "telephone_number": "973-763-8175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1173 KENNEDY BLVD",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023132",
            "telephone_number": "201-339-1177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRSCHBERG",
        "first_name": "CRAIG",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NJ",
            "license": "DI103097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

Verify at the official NPI Registry.