Individual provider Active NPI

Robert Joel Federman, DDS

  • Dentist
  • Fort Lee, NJ
National Provider Identifier
1962617480
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22D101144100 Issued in NJ
Practice address
2185 Lemoine Ave Ste 1K
Fort Lee, NJ 07024-6030
Phone
(201) 592-7727
Fax
(201) 592-1279
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22D101144100 NJ Primary

Addresses

Primary practice location

2185 Lemoine Ave Ste 1K
Fort Lee, NJ 07024-6030

Mailing address

2185 Lemoine Ave Ste 1K
Fort Lee, NJ 07024-6030
Phone (201) 592-7727

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
22D101144100NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
First Choice Dental Group, LLC Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962617480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2185 LEMOINE AVE STE 1K",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246030",
            "telephone_number": "201-592-7727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2185 LEMOINE AVE STE 1K",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246030",
            "telephone_number": "201-592-7727",
            "fax_number": "201-592-1279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FEDERMAN",
        "first_name": "ROBERT",
        "middle_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22D101144100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Lee, 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.

Verify at the official NPI Registry.