Active NPI
Edward Gewiss, D.M.D.
- General Practice Dentistry
- Old Bridge, NJ
National Provider Identifier
1962614107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D08872
- Practice address
- 30 State Highway 18
Old Bridge, NJ 08857 - Phone
- (732) 254-5999
- Fax
- (732) 651-1454
- NPI assigned
- May 3, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D08872 | NJ | Primary |
Addresses
Primary practice location
30 State Highway 18
Old Bridge, NJ 08857
Mailing address
30 State Highway 18
Old Bridge, NJ 08857
Phone (732) 254-5999
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 |
|---|---|---|---|
| D08872 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962614107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 STATE HIGHWAY 18",
"city": "OLD BRIDGE",
"state": "NJ",
"postal_code": "08857",
"telephone_number": "732-254-5999",
"fax_number": "732-651-1454"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 STATE HIGHWAY 18",
"city": "OLD BRIDGE",
"state": "NJ",
"postal_code": "08857",
"telephone_number": "732-254-5999",
"fax_number": "732-651-1454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEWISS",
"first_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "D08872",
"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 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.