Individual provider Active NPI

Marc Steven Plotkin, D.D.S.

  • General Practice Dentistry
  • Elizabeth, NJ
National Provider Identifier
1811094808
Registry record updated Jun 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12850 Issued in NJ
Practice address
1151 E Jersey St
Elizabeth, NJ 07201-2310
Phone
(908) 351-2106
Fax
(908) 351-4910
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 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 12850 NJ Primary

Addresses

Primary practice location

1151 E Jersey St
Elizabeth, NJ 07201-2310

Mailing address

1151 E Jersey St
Elizabeth, NJ 07201-2310
Phone (908) 351-2106

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
12850NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lysandra Plotkin, D.M.D LLC 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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1811094808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 E JERSEY ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072012310",
            "telephone_number": "908-351-2106",
            "fax_number": "908-351-4910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 E JERSEY ST",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072012310",
            "telephone_number": "908-351-2106",
            "fax_number": "908-351-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PLOTKIN",
        "first_name": "MARC",
        "middle_name": "STEVEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "12850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; 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.