Laurence Bremmer, DMD
Individual provider Active NPI General Practice Dentistry · Mountainside, NJ
NPI 1992714844 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992714844
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D11517 (NJ)
- Practice address
- 1162 Springfield Ave.
Mountainside, NJ 07092 - Phone
- (908) 789-2777
- NPI assigned
- Aug 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150730012824 | NJ | Order and Referring Only - Oral Surgery |
4789998089 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D11517 | NJ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr. Laurence Bremmer, DMD, PA | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D11517 | NJ | Yes |
Addresses
Primary practice location
1162 Springfield Ave.
Mountainside, NJ 07092
Mailing address
1162 Springfield Ave.
Mountainside, NJ 07092
Phone (908) 789-2777
Other providers in Mountainside, NJ
- Boomerang Investments LLC
- Megan Borbely
- Diannis Elaine Borras
- Boston Brace International Inc.
- Cheryl Jean Botelho
- Danielle R Brooks
- John J Bruno
- Charles Richard Bunin
- Katherine Elyse Cabrera
- Donna M Camara
All providers in Mountainside, NJ · General Practice Dentistry in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.