Joachim M Provenzano, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DI01812900 Issued in NJ

Practice address

984 Brass Castle Rd
Belvidere, NJ 07823-2752

Phone

(908) 475-3641

NPI assigned

Mar 26, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Belvidere Dental Associates, P.C.

  • General Practice Dentistry
  • Belvidere, NJ
  • NPI 1215152129
  NPD (past)

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942328562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 WOLF HILL DR",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070595327",
            "telephone_number": "908-580-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "984 BRASS CASTLE RD",
            "city": "BELVIDERE",
            "state": "NJ",
            "postal_code": "078232752",
            "telephone_number": "908-475-3641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROVENZANO",
        "first_name": "JOACHIM",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI01812900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NJ Foot and Ankle Restoration Inc
• Aubrey L Nocek, CRNP
• Dineshkumar A Patel
• Elizabeth A Pearce, PSY.D.
• Primary Care Partners LLC (Pequest Family Medicine-Primary Care Partners Affiliate)
• Amannda L Richline, DPM, PC
• Rite Aid of New Jersey Inc (Rite Aid Pharmacy 00220)
• Rite-Aid Pharmacy
• Carolina Nativia Rivera
• Eric Rodriguez, D.C.

• Dentist in Belvidere, NJ
• Providers in Belvidere, NJ by specialty
• Dentist 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.