NPIMap

Organization Active NPI

Medford Endodontics

  • Endodontics
  • Medford, NJ
National Provider Identifier
1871500405
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DI008099 Issued in NJ
Legal business name
MEDFORD ENDODONTICS
Practice address
30 Jackson Rd
Suite C-2
Medford, NJ 08055-9283
Phone
(609) 654-2772
Fax
(609) 953-5674
NPI assigned
Aug 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Carl Tinkelman, DMSNPI 1548436009
Title
President
Phone
(609) 654-2772

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
EndodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223E0200X DI008099 NJ Primary

Addresses

Primary practice location

30 Jackson Rd
Suite C-2
Medford, NJ 08055-9283

Mailing address

30 Jackson Rd
Suite C-2
Medford, NJ 08055-9283
Phone (609) 654-2772

Other identifiers 2

IdentifierTypeStateIssuer
1115730OtherNJHORIZON MERCY
600149OtherPAUNITED CONCORDIA

National Provider Directory

National Provider Directory

Locations

30 Jackson Rd
Ste C2
Medford, NJ 08055
Phone (609) 654-2772

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1871500405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 JACKSON RD",
            "address_2": "SUITE C-2",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080559283",
            "telephone_number": "609-654-2772",
            "fax_number": "609-953-5674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 JACKSON RD",
            "address_2": "SUITE C-2",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080559283",
            "telephone_number": "609-654-2772",
            "fax_number": "609-953-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFORD ENDODONTICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TINKELMAN",
        "authorized_official_first_name": "CARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "609-654-2772",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "NJ",
            "license": "DI008099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON MERCY",
            "identifier": "1115730",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "600149",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.