Individual provider Active NPI

George R Mann Jr., D.D.S.

  • General Practice Dentistry
  • Kinnelon, NJ
National Provider Identifier
1831306869
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22D100977700 Issued in NJ
Practice address
15 Kiel Avenue
Suite #202
Kinnelon, NJ 07405
Phone
(973) 492-1670
Fax
(973) 838-0913
NPI assigned
May 17, 2007
Sex
Male
Sole proprietor
Yes

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 22D100977700 NJ Primary

Addresses

Primary practice location

15 Kiel Avenue
Suite #202
Kinnelon, NJ 07405

Mailing address

15 Kiel Ave.
Suite #202
Kinnelon, NJ 07405
Phone (973) 492-1670

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
I20150601000778 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3870814023

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22D100977700NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831306869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 KIEL AVE.",
            "address_2": "SUITE #202",
            "city": "KINNELON",
            "state": "NJ",
            "postal_code": "07405",
            "telephone_number": "973-492-1670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 KIEL AVENUE",
            "address_2": "SUITE #202",
            "city": "KINNELON",
            "state": "NJ",
            "postal_code": "07405",
            "telephone_number": "973-492-1670",
            "fax_number": "973-838-0913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANN",
        "first_name": "GEORGE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22D100977700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kinnelon, NJ

Sources for this page

Verify at the official NPI Registry.