Individual provider Active NPI

Andrew Dubman, D.M.D

  • General Practice Dentistry
  • Forked River, NJ
National Provider Identifier
1972639128
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17953 Issued in NJ
Practice address
131 S Main St
Forked River, NJ 08731-3635
Phone
(732) 750-0707
Fax
(732) 750-4240
NPI assigned
Feb 24, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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
General Practice Dentistry 1223G0001X 17953 NJ Primary

Addresses

Primary practice location

131 S Main St
Forked River, NJ 08731-3635

Mailing address

1030 Saint Georges Ave
Avenel, NJ 07001-1390

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
I20150306001223 NJ Order and Referring Only - DentistPractitioner - Dentist 2264758390

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17953NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Dental of Lacey, LLC General Practice 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1172275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972639128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 SAINT GEORGES AVE",
            "city": "AVENEL",
            "state": "NJ",
            "postal_code": "070011390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 S MAIN ST",
            "city": "FORKED RIVER",
            "state": "NJ",
            "postal_code": "087313635",
            "telephone_number": "732-750-0707",
            "fax_number": "732-750-4240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUBMAN",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "17953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forked River, NJ

Sources for this page

Verify at the official NPI Registry.