William Martin Kozuch, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI01297000 Issued in NJ

Practice address

520 Beckett Rd Ste 100
Logan Township, NJ 08085-1732

Phone

(856) 467-0606

NPI assigned

Mar 30, 2008

Last updated

Mar 30, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1206835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206835200000",
    "number": "1972775948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 BECKETT RD STE 100",
            "city": "LOGAN TOWNSHIP",
            "state": "NJ",
            "postal_code": "080851732",
            "telephone_number": "856-467-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 BECKETT RD STE 100",
            "city": "LOGAN TOWNSHIP",
            "state": "NJ",
            "postal_code": "080851732",
            "telephone_number": "856-467-0606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZUCH",
        "first_name": "WILLIAM",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-30",
        "last_updated": "2008-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI01297000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristy Lynne Henner, MOT, OTR/L
• Holistic Healing Counseling Services
• Allison Jessar, PSYD
• Harshila Kakkilaya, MD
• Christian Robert Klumpp
• Annmarie Asis Latham, PA-C
• Logan Township School District
• Jan P Long, MSN ANP-C
• Natalie J Lowe
• Mark Giorno DMD & Associates PA (Main Street Dental)

• General Practice Dentistry in Logan Township, NJ
• Providers in Logan Township, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.