Stephen E Demyer, D.D.S

Key facts

NPI

1821170671

Entity type

Individual (NPI type 1)

Primary specialty

General Practice Dentistry 1223G0001X

License

19353 (NJ)

Practice address

924 Route10
Randolph, NJ 07869

Phone

(973) 584-0008

Fax

(973) 584-5663

NPI assigned

Oct 20, 2006

Sex

Male

Sole proprietor

No

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.

• Charmoy Dental Associates General Practice Dentistry · Randolph, NJ · NPI 1003697426
  NPD (past) GENERAL PRACTICE

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 9, 2007.

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1821170671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "408 COLUMBIA AVE",
            "city": "CLIFFSIDE PARK",
            "state": "NJ",
            "postal_code": "070101904",
            "telephone_number": "201-747-7780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 ROUTE10",
            "city": "RANDOLPH",
            "state": "NJ",
            "postal_code": "07869",
            "telephone_number": "973-584-0008",
            "fax_number": "973-584-5663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMYER",
        "first_name": "STEPHEN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "19353",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Randolph, NJ · General Practice Dentistry in New Jersey