Michael Benjamin Heller, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D04070200 Issued in NJ

Practice address

120 County Rd
Tenafly, NJ 07670-1854

Phone

(201) 568-1190

NPI assigned

May 1, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1750501789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 LAKEVIEW DR",
            "city": "TOMKINS COVE",
            "state": "NY",
            "postal_code": "109861615",
            "telephone_number": "845-429-0363",
            "fax_number": "240-208-2176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 COUNTY RD",
            "city": "TENAFLY",
            "state": "NJ",
            "postal_code": "076701854",
            "telephone_number": "201-568-1190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLER",
        "first_name": "MICHAEL",
        "middle_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "D04070200",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0111287",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Tenafly, NJ
• Providers in Tenafly, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.