Fredric Carl Mazza, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

22DI02379800 Issued in NJ

Practice address

150 Bergen St
Uh, Dept of Oral and Maxillofacial Surgery, RM C-401
Newark, NJ 07103-2496

Phone

(973) 280-2297

NPI assigned

Sep 10, 2008

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 PA

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

Specialty

Oral Surgery

Education

Other, 2008

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Carl Joseph Milano, D.M.D.

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Easton, PA
  • NPI 1720199805
  Medicare reassignment

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264982400000",
    "number": "1982853214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 FOREST DR",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "074441516",
            "telephone_number": "973-280-2297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 BERGEN ST",
            "address_2": "UH, DEPT OF ORAL AND MAXILLOFACIAL SURGERY, RM C-401",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071032496",
            "telephone_number": "973-280-2297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZA",
        "first_name": "FREDRIC",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-10",
        "last_updated": "2010-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI02379800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frances Rieth Maynard, FNP-BC PHD
• Latisse Monique Mays-Stovall, M.D.
• Nada Mays, MS, RDN
• Victoria Mazola, APN
• Jessica M Mazur
• Fermina M Mazzella, MD
• Daniel Mazzorana, DO
• Bridget McAndrew
• Erin McCaffrey, PHARMD
• Kwame McCain

• Oral and Maxillofacial Surgery (Dentist) in Newark, NJ
• Providers in Newark, NJ by specialty
• Oral and Maxillofacial Surgery (Dentist) in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.