Individual provider Active NPI

Michael Joseph Cisar, D.M.D

  • General Practice Dentistry
  • Tinton Falls, NJ
National Provider Identifier
1831269372
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
21287 Issued in NJ
Practice address
709 Sycamore Ave
Tinton Falls, NJ 07701-4946
Phone
(732) 842-6300
Fax
(732) 842-3467
NPI assigned
Nov 9, 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 21287 NJ Primary

Addresses

Primary practice location

709 Sycamore Ave
Tinton Falls, NJ 07701-4946

Mailing address

709 Sycamore Ave
Tinton Falls, NJ 07701-4946
Phone (732) 842-6300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150209000662 NJ Order and Referring Only - DentistPractitioner - Dentist 2163747460

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21287NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831269372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "709 SYCAMORE AVE",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014946",
            "telephone_number": "732-842-6300",
            "fax_number": "732-842-3467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 SYCAMORE AVE",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077014946",
            "telephone_number": "732-842-6300",
            "fax_number": "732-842-3467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CISAR",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "21287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinton Falls, NJ

Sources for this page

Verify at the official NPI Registry.