Individual provider Active NPI

Jeffrey Robert Schwartz, D.M.D.

  • Prosthodontics
  • Fort Lee, NJ
National Provider Identifier
1790798254
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
12180 Issued in NJ
Practice address
489 Edsall Blvd
Fort Lee, NJ 07024-1946
Phone
(201) 224-9000
Fax
(201) 224-0718
NPI assigned
Aug 15, 2006
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
Prosthodontics 1223P0700X 12180 NJ Primary

Addresses

Primary practice location

489 Edsall Blvd
Fort Lee, NJ 07024-1946

Mailing address

489 Edsall Blvd
Fort Lee, NJ 07024-1946
Phone (201) 224-9000

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
I20160127000900 NJ Order and Referring Only - DentistPractitioner - Dentist 5698078566

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12180NJMDProsthodontist

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790798254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "489 EDSALL BLVD",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070241946",
            "telephone_number": "201-224-9000",
            "fax_number": "201-224-0718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 EDSALL BLVD",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070241946",
            "telephone_number": "201-224-9000",
            "fax_number": "201-224-0718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWARTZ",
        "first_name": "JEFFREY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NJ",
            "license": "12180",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, NJ

Sources for this page

Verify at the official NPI Registry.