Active NPI
Jacklyn Maduro, D.M.D.
- General Practice Dentistry
- Morristown, NJ
National Provider Identifier
1992708994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DI02263500
- Practice address
- 10 Pine St
Morristown, NJ 07960-4167 - Phone
- (973) 267-0270
- NPI assigned
- May 23, 2005
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DI02263500 | NJ | Primary |
Addresses
Primary practice location
10 Pine St
Morristown, NJ 07960-4167
Mailing address
10 Pine St
Morristown, NJ 07960-4167
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 28, 2021 through Jun 28, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI02263500 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1116806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274745600000",
"number": "1992708994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10 PINE ST",
"city": "MORRISTOWN",
"state": "NJ",
"postal_code": "079604167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10 PINE ST",
"city": "MORRISTOWN",
"state": "NJ",
"postal_code": "079604167",
"telephone_number": "973-267-0270"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADURO",
"first_name": "JACKLYN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-05-23",
"last_updated": "2010-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "DI02263500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Morristown, NJ
- Madison Avenue Chiropractic Group, P.C.
- Madison Avenue Oral & Maxillofacial Surgery Associates, LLC
- Madison Family Chiropractic Inc
- Madison Internal Medicine Associates, P.a.
- Jennifer Madison, NP
- Matthew Blaise Maffey, DO
- Cassidy Maggio, PHARMD
- Jory G Magidson I, MD
- Katelyn Maglione, AGACNP-BC
- Kristin Magotch, LPC, NCC, M.ED
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.