Individual provider Active NPI

Michal Rosenbach, DMD

  • Dentist
  • Newark, NJ
National Provider Identifier
1881870491
Registry record updated Jan 14, 2008
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02356800 Issued in NJ
Practice address
110 Bergen St
Newark, NJ 07101-1709
Phone
(973) 972-7040
NPI assigned
Jan 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02356800 NJ Primary

Addresses

Primary practice location

110 Bergen St
Newark, NJ 07101-1709

Mailing address

241 Brook Ave
#3
Passaic, NJ 07055-3311
Phone (973) 249-0478

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150622000233 NJ Order and Referring Only - DentistPractitioner - Dentist 3173834983

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200268800000",
    "number": "1881870491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "241 BROOK AVE",
            "address_2": "#3",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070553311",
            "telephone_number": "973-249-0478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BERGEN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071011709",
            "telephone_number": "973-972-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSENBACH",
        "first_name": "MICHAL",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-14",
        "last_updated": "2008-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02356800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

Verify at the official NPI Registry.