Active NPI
Marvin Solomon, D.D.S.
- Periodontics
- East Brunswick, NJ
National Provider Identifier
1811283047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 22DI00810800
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI00810800 | NJ | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Periodontics
- East Brunswick, NJ
- NPI 1003038670
-
- Dental Clinic/Center
- East Brunswick, NJ
- NPI 1790077097
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.