Individual provider Active NPI

Richard Joseph Gawarzewski, DMD

  • General Practice Dentistry
  • Berlin, NJ
National Provider Identifier
1790884443
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI01463900 Issued in NJ
Practice address
3 Harker Avenue
Suite E
Berlin, NJ 08009-2300
Phone
(856) 767-0053
Fax
(756) 767-2599
NPI assigned
Sep 21, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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
General Practice Dentistry 1223G0001X 22DI01463900 NJ Primary

Addresses

Primary practice location

3 Harker Avenue
Suite E
Berlin, NJ 08009-2300

Mailing address

3 Harker Avenue
Suite E
Berlin, NJ 08009-2300
Phone (856) 767-0053

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
I20150609001725 NJ Order and Referring Only - DentistPractitioner - Dentist 5597086058

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI01463900NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790884443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 HARKER AVENUE",
            "address_2": "SUITE E",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080092300",
            "telephone_number": "856-767-0053",
            "fax_number": "756-767-2599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 HARKER AVENUE",
            "address_2": "SUITE E",
            "city": "BERLIN",
            "state": "NJ",
            "postal_code": "080092300",
            "telephone_number": "856-767-0053",
            "fax_number": "756-767-2599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAWARZEWSKI",
        "first_name": "RICHARD",
        "middle_name": "JOSEPH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI01463900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, NJ

Sources for this page

Verify at the official NPI Registry.