Samuel Stanley Tatem Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI17644 Issued in NJ

Practice address

179 Cedar LN Ste G
Teaneck, NJ 07666-4304

Phone

(201) 836-0029

Fax

(201) 836-9529

NPI assigned

May 23, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: samuel.tatem.p1@direct.memhc.nextgenshare.com

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.

• City of Newark

  dba Newark Department of Health and Community Wellness

  • Community Health Clinic/Center
  • Newark, NJ
  • NPI 1356561278
  Medicare reassignment NPD
• City of Newark

  dba Newark Department of Health and Community Wellness/Mary Eliza Mahoney

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
  • NPI 1972206258
  NPD
• City of Newark

  dba Newark Department of Health and Community Welllness

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
  • NPI 1295958908
  NPD (past)

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881804383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 CEDAR LN STE G",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664304",
            "telephone_number": "201-836-0029",
            "fax_number": "201-836-9529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 CEDAR LN STE G",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076664304",
            "telephone_number": "201-836-0029",
            "fax_number": "201-836-9529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TATEM",
        "first_name": "SAMUEL",
        "middle_name": "STANLEY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI17644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Randy S Tartacoff, MD
• Albert Tartini, M.D.
• Erica Marie Taryla
• Sarah Tarzik, ATR-BC
• Berk Taskin
• Lusine Tatevosyan, PA
• Ruth Tavares, REGISTERED NURSE
• Haim Tawil, DMD
• Vyron Tayag, CNIM
• Jaquellah Taylor, MD

• General Practice Dentistry in Teaneck, NJ
• Providers in Teaneck, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.