Individual provider Active NPI

Philip Zaveloff, D.D.S.

  • Endodontics
  • Lakewood, NJ
National Provider Identifier
1881746808
Registry record updated Jul 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
22D102785100 Issued in NY
Practice address
402 W County Line Rd
Lakewood, NJ 08701-1211
Phone
(732) 534-3244
Fax
(732) 534-3243
NPI assigned
Jan 18, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 051726 NY
Endodontics 1223E0200X 22D102785100 NY Primary

Addresses

Primary practice location

402 W County Line Rd
Lakewood, NJ 08701-1211

Mailing address

402 W County Line Rd
Lakewood, NJ 08701-1211
Phone (732) 534-3244

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
051726NYMDEndodontist
22D102785100NYMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657497600000",
    "number": "1881746808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 W COUNTY LINE RD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087011211",
            "telephone_number": "732-534-3244",
            "fax_number": "732-534-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 W COUNTY LINE RD",
            "city": "LAKEWOOD",
            "state": "NJ",
            "postal_code": "087011211",
            "telephone_number": "732-534-3244",
            "fax_number": "732-534-3243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAVELOFF",
        "first_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2022-07-11",
        "certification_date": "2022-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "051726",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "22D102785100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2022; 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.