Individual provider Active NPI

Vincent Tavormina, DDS

  • General Practice Dentistry
  • Millburn, NJ
National Provider Identifier
1871641340
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11336 Issued in NJ
Practice address
96 Millburn Ave
Millburn, NJ 07041-1944
Phone
(973) 761-5090
Fax
(973) 761-5097
NPI assigned
Jan 8, 2007
Last updated
Jan 24, 2013By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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 11336 NJ Primary

Addresses

Primary practice location

96 Millburn Ave
Millburn, NJ 07041-1944

Mailing address

96 Millburn Ave
Millburn, NJ 07041-1944
Phone (973) 761-5090

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
11336NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1871641340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 MILLBURN AVE",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411944",
            "telephone_number": "973-761-5090",
            "fax_number": "973-761-5097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 MILLBURN AVE",
            "city": "MILLBURN",
            "state": "NJ",
            "postal_code": "070411944",
            "telephone_number": "973-761-5090",
            "fax_number": "973-761-5097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAVORMINA",
        "first_name": "VINCENT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "11336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millburn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2013; 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.