Individual provider Active NPI

Dominick A. Serini, D.M.D

  • General Practice Dentistry
  • Holmdel, NJ
National Provider Identifier
1801062005
Registry record updated May 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22D102262600 Issued in NJ
Practice address
74 Union Ave
Holmdel, NJ 07733-1117
Phone
(732) 335-0022
Fax
(732) 335-0021
NPI assigned
May 7, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2008

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 22D102262600 NJ Primary

Addresses

Primary practice location

74 Union Ave
Holmdel, NJ 07733-1117

Mailing address

74 Union Ave
Holmdel, NJ 07733-1117
Phone (732) 335-0022

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
I20150612001339 NJ Order and Referring Only - DentistPractitioner - Dentist 7416268743

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22D102262600NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Serini Family Dentistry General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210118400000",
    "number": "1801062005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 UNION AVE",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331117",
            "telephone_number": "732-335-0022",
            "fax_number": "732-335-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 UNION AVE",
            "city": "HOLMDEL",
            "state": "NJ",
            "postal_code": "077331117",
            "telephone_number": "732-335-0022",
            "fax_number": "732-335-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERINI",
        "first_name": "DOMINICK",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-07",
        "last_updated": "2008-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22D102262600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holmdel, NJ

Sources for this page

Verify at the official NPI Registry.