Individual provider Active NPI

Hector F Morales Medina, DDS

  • General Practice Dentistry
  • Red Bank, NJ
National Provider Identifier
1942392261
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
19674 Issued in NJ
Practice address
1 Branch Ave
Red Bank, NJ 07701-2201
Phone
(732) 345-7100
Fax
(732) 345-7440
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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 19674 NJ Primary

Addresses

Primary practice location

1 Branch Ave
Red Bank, NJ 07701-2201

Mailing address

1 Branch Ave
Red Bank, NJ 07701-2201
Phone (732) 345-7100

Other identifiers 1

IdentifierTypeStateIssuer
223566125OtherNJTAX ID

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
I20151019000048 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2163731951

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19674NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1942392261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BRANCH AVE",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077012201",
            "telephone_number": "732-345-7100",
            "fax_number": "732-345-7440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BRANCH AVE",
            "city": "RED BANK",
            "state": "NJ",
            "postal_code": "077012201",
            "telephone_number": "732-345-7100",
            "fax_number": "732-345-7440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORALES MEDINA",
        "first_name": "HECTOR",
        "middle_name": "F",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "19674",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "223566125",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Bank, NJ

Sources for this page

Verify at the official NPI Registry.