Individual provider Active NPI

Charles Keeler Paxson, DMD

  • General Practice Dentistry
  • Pleasantville, NJ
National Provider Identifier
1831200435
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22D100884400 Issued in NJ
Practice address
931 N Main Street
Suite A3
Pleasantville, NJ 08232
Phone
(609) 646-3890
Fax
(609) 646-3751
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 22D100884400 NJ Primary

Addresses

Primary practice location

931 N Main Street
Suite A3
Pleasantville, NJ 08232

Mailing address

814 New York Ave
Absecon, NJ 08201
Phone (609) 646-3434

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
22D100884400NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831200435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 NEW YORK AVE",
            "city": "ABSECON",
            "state": "NJ",
            "postal_code": "08201",
            "telephone_number": "609-646-3434",
            "fax_number": "609-646-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "931 N MAIN STREET",
            "address_2": "SUITE A3",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "08232",
            "telephone_number": "609-646-3890",
            "fax_number": "609-646-3751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAXSON",
        "first_name": "CHARLES",
        "middle_name": "KEELER",
        "name_prefix": "Mr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22D100884400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasantville, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.