Active NPI
Marc Mehlman, D.M.D.
- Dentist
- Eatontown, NJ
National Provider Identifier
1942558754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 15236
- Practice address
- 613 Hope Rd
BLDG. 5
Eatontown, NJ 07724-1278 - Phone
- (732) 542-4433
- Fax
- (732) 389-0304
- NPI assigned
- Aug 28, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 15236 | NJ | Primary |
Addresses
Primary practice location
613 Hope Rd
BLDG. 5
Eatontown, NJ 07724-1278
Mailing address
613 Hope Rd
BLDG. 5
Eatontown, NJ 07724-1278
Phone (732) 542-4433
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15236 | NJ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346112000000",
"number": "1942558754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "613 HOPE RD",
"address_2": "BLDG. 5",
"city": "EATONTOWN",
"state": "NJ",
"postal_code": "077241278",
"telephone_number": "732-542-4433",
"fax_number": "732-389-0304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "613 HOPE RD",
"address_2": "BLDG. 5",
"city": "EATONTOWN",
"state": "NJ",
"postal_code": "077241278",
"telephone_number": "732-542-4433",
"fax_number": "732-389-0304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEHLMAN",
"first_name": "MARC",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-08-28",
"last_updated": "2012-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "15236",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eatontown, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.