Individual provider Active NPI

Jonathan S Ungar, DMD

  • General Practice Dentistry
  • Lakewood, NJ
National Provider Identifier
1790821262
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02263800 Issued in NJ
Practice address
110 Hillside Blvd Ste 5
Lakewood, NJ 08701-3394
Phone
(732) 333-3383
Fax
(815) 301-9612
NPI assigned
Jan 30, 2007
Last updated
Nov 21, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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 22DI02263800 NJ Primary
General Practice Dentistry 1223G0001X 051567-1 NY

Addresses

Primary practice location

110 Hillside Blvd Ste 5
Lakewood, NJ 08701-3394

Mailing address

110 Hillside Blvd Ste 5
Lakewood, NJ 08701-3394
Phone (732) 333-3383

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
22DI02263800NJMDGeneral Practice Dentistry
051567-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Digitally Enhanced Dentistry General Practice Past Accepting new patients
Center for Dental Arts General Practice PastSince Nov 1, 2020 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1790821262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HILLSIDE BLVD STE 5",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087013394",
            "telephone_number": "732-333-3383",
            "fax_number": "815-301-9612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HILLSIDE BLVD STE 5",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087013394",
            "telephone_number": "732-333-3383",
            "fax_number": "815-301-9612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UNGAR",
        "first_name": "JONATHAN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02263800",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "051567-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.