Individual provider Active NPI

Manaf Saker, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Glen Rock, NJ
National Provider Identifier
1861417040
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
22DI01979200 Issued in NJ
Practice address
385 S Maple Ave
Suite 207
Glen Rock, NJ 07452-1543
Phone
(201) 444-5355
Fax
(201) 444-5502
NPI assigned
Jul 12, 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
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 22DI01979200 NJ Primary

Addresses

Primary practice location

385 S Maple Ave
Suite 207
Glen Rock, NJ 07452-1543

Mailing address

385 S Maple Ave
Suite 207
Glen Rock, NJ 07452-1543
Phone (201) 444-5355

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130524000461 NJ Order and Referring Only - Maxillofacial SurgeryPractitioner - Maxillofacial Surgery 9638317076

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI01979200NJMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Ridgewood Oral Surgery Center LLC Oral and Maxillofacial Surgery PastSince Jul 25, 2021 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861417040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 S MAPLE AVE",
            "address_2": "SUITE 207",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074521543",
            "telephone_number": "201-444-5355",
            "fax_number": "201-444-5502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 S MAPLE AVE",
            "address_2": "SUITE 207",
            "city": "GLEN ROCK",
            "state": "NJ",
            "postal_code": "074521543",
            "telephone_number": "201-444-5355",
            "fax_number": "201-444-5502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAKER",
        "first_name": "MANAF",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI01979200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Rock, NJ

Sources for this page

Verify at the official NPI Registry.