Individual provider Active NPI

Justin Shane Dinowitz, DMD

  • Pediatric Dentistry
  • Old Bridge, NJ
National Provider Identifier
1912521865
Registry record updated Mar 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
22DI02830300 Issued in NJ
Practice address
2455 Route 516 FL 1
Old Bridge, NJ 08857-1892
Phone
(732) 679-2323
NPI assigned
Jun 5, 2020
Last updated
Mar 26, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Dentistry 1223P0221X 22DI02830300 NJ Primary

Addresses

Primary practice location

2455 Route 516 FL 1
Old Bridge, NJ 08857-1892

Mailing address

124 Micki Dr
Morganville, NJ 07751-1659
Phone (732) 535-0538

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
22DI02830300NJMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Justin Dinowitz DMD LLC Pediatric Dentistry Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679788800000",
    "number": "1912521865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 MICKI DR",
            "city": "MORGANVILLE",
            "state": "NJ",
            "postal_code": "077511659",
            "telephone_number": "732-535-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 ROUTE 516 FL 1",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088571892",
            "telephone_number": "732-679-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DINOWITZ",
        "first_name": "JUSTIN",
        "middle_name": "SHANE",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-05",
        "last_updated": "2023-03-26",
        "certification_date": "2023-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02830300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2023; 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.