Individual provider Active NPI

Marvin Solomon, D.D.S.

  • Periodontics
  • East Brunswick, NJ
National Provider Identifier
1811283047
Registry record updated Jun 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
22DI00810800 Issued in NJ
Practice address
A3 Cornwall Dr
East Brunswick, NJ 08816-3352
Phone
(732) 257-7300
Fax
(732) 257-7316
NPI assigned
Jun 27, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 22DI00810800 NJ Primary

Addresses

Primary practice location

A3 Cornwall Dr
East Brunswick, NJ 08816-3352

Mailing address

128 Lawrence Dr
Short Hills, NJ 07078-3125
Phone (908) 510-4040

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
22DI00810800NJMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
North Jersey Laser Periodontics Past Accepting new patients
Marvin Solomon, D.D.S., P.a. Periodontics Past Accepting new patients

Organizations & group practices 2

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": "1309132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309132800000",
    "number": "1811283047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 LAWRENCE DR",
            "city": "SHORT HILLS",
            "state": "NJ",
            "postal_code": "070783125",
            "telephone_number": "908-510-4040",
            "fax_number": "973-379-6472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "A3 CORNWALL DR",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088163352",
            "telephone_number": "732-257-7300",
            "fax_number": "732-257-7316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "MARVIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-27",
        "last_updated": "2011-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22DI00810800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2011; 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.