Siegfried Willem Tjonajong, DMD MSD

Primary specialty

DentistTaxonomy code 122300000X

License

22DIO1785000 Issued in NJ

Practice address

947 Linwood Ave Ste 1
Oral & Maxillofacial Prosthodontics
Ridgewood, NJ 07450-2939

Phone

(201) 670-4800

Fax

(201) 670-6776

NPI assigned

Oct 29, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1225238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225238400000",
    "number": "1801049234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "947 LINWOOD AVENUE SUITE 1 NORTH",
            "address_2": "ORAL & MAXILLOFACIAL PROSTHODONTICS",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "07450",
            "telephone_number": "201-670-4800",
            "fax_number": "201-670-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 LINWOOD AVE STE 1",
            "address_2": "ORAL & MAXILLOFACIAL PROSTHODONTICS",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074502939",
            "telephone_number": "201-670-4800",
            "fax_number": "201-670-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TJONAJONG",
        "first_name": "SIEGFRIED",
        "middle_name": "WILLEM",
        "credential": "DMD MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-10-29",
        "last_updated": "2008-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DIO1785000",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "NJ",
            "license": "NJ-3807",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2008; 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.