Individual provider Active NPI

Jessica Marinoff, D.M.D.

  • General Practice Dentistry
  • Camden, NJ
National Provider Identifier
1881984649
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02464800 Issued in NJ
Practice address
1000 Atlantic Ave
Camden, NJ 08104-1132
Phone
(215) 317-5869
Fax
(856) 246-3550
NPI assigned
Apr 13, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 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 22DI02464800 NJ Primary

Addresses

Primary practice location

1000 Atlantic Ave
Camden, NJ 08104-1132

Mailing address

1000 Atlantic Ave
Camden, NJ 08104-1132
Phone (215) 317-5869

Other identifiers 1

IdentifierTypeStateIssuer
0290661MedicaidNJ

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
22DI02464800NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1881984649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 ATLANTIC AVE",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081041132",
            "telephone_number": "215-317-5869",
            "fax_number": "856-246-3550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 ATLANTIC AVE",
            "city": "CAMDEN",
            "state": "NJ",
            "postal_code": "081041132",
            "telephone_number": "215-317-5869",
            "fax_number": "856-246-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARINOFF",
        "first_name": "JESSICA",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-13",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02464800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0290661",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.