Individual provider Active NPI

Marwan Bassil Bassil, D.M.D.

  • General Practice Dentistry
  • Bridgewater, NJ
National Provider Identifier
1801916614
Registry record updated Feb 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DI 20751 Issued in NJ
Practice address
676 Route 202/206
Bridgewater, NJ 08807-1761
Phone
(908) 722-6666
Fax
(908) 722-6667
NPI assigned
Mar 29, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2015

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 DI 20751 NJ Primary

Addresses

Primary practice location

676 Route 202/206
Bridgewater, NJ 08807-1761

Mailing address

676 Route 202/206
Bridgewater, NJ 08807-1761
Phone (908) 722-6666

Other identifiers 1

IdentifierTypeStateIssuer
273514712OtherNJTAX ID

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
I20150313001160 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 7214253053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI 20751NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424304000000",
    "number": "1801916614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "676 ROUTE 202/206",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088071761",
            "telephone_number": "908-722-6666",
            "fax_number": "908-722-6667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "676 ROUTE 202/206",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088071761",
            "telephone_number": "908-722-6666",
            "fax_number": "908-722-6667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASSIL",
        "first_name": "MARWAN",
        "middle_name": "BASSIL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2015-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI 20751",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "273514712",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

Verify at the official NPI Registry.