Teresa Louise Destefano, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI16957 Issued in NJ

Practice address

1130 US Highway 202
Raritan, NJ 08869-1490

Phone

(908) 722-8256

Fax

(908) 722-8499

NPI assigned

Jan 12, 2007

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902956782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 US HIGHWAY 202",
            "city": "RARITAN",
            "state": "NJ",
            "postal_code": "088691490",
            "telephone_number": "908-722-8256",
            "fax_number": "908-722-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 US HIGHWAY 202",
            "city": "RARITAN",
            "state": "NJ",
            "postal_code": "088691490",
            "telephone_number": "908-722-8256",
            "fax_number": "908-722-8499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTEFANO",
        "first_name": "TERESA",
        "middle_name": "LOUISE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI16957",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Raritan, NJ
• Providers in Raritan, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.