Individual provider Active NPI

Robert Antmann, D.D.S.

  • General Practice Dentistry
  • Perth Amboy, NJ
National Provider Identifier
1962744854
Registry record updated Mar 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI01586000 Issued in NJ
Practice address
1107 Convery Blvd
Perth Amboy, NJ 08861-1937
Phone
(732) 442-0037
NPI assigned
Mar 19, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2013

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 22DI01586000 NJ Primary

Addresses

Primary practice location

1107 Convery Blvd
Perth Amboy, NJ 08861-1937

Mailing address

1107 Convery Blvd
Perth Amboy, NJ 08861-1937
Phone (732) 442-0037

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
I20150602002903 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9133440134

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI01586000NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1363651200000",
    "number": "1962744854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1107 CONVERY BLVD",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088611937",
            "telephone_number": "732-442-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 CONVERY BLVD",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088611937",
            "telephone_number": "732-442-0037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTMANN",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-19",
        "last_updated": "2013-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI01586000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

Verify at the official NPI Registry.