Individual provider Active NPI

Steven Anthony Dirienzo, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Bayonne, NJ
National Provider Identifier
1992791966
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DI021870 Issued in NJ
Practice address
925 Broadway
Bayonne, NJ 07002-3088
Phone
(201) 858-1400
NPI assigned
Sep 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DI021870 NJ Primary

Addresses

Primary practice location

925 Broadway
Bayonne, NJ 07002-3088

Mailing address

925 Broadway
Bayonne, NJ 07002-3088
Phone (201) 858-1400

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
I20151015001245 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2163731068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI021870NJMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Gaetano G Spinnato DMD MD LLC Oral and Maxillofacial Surgery CurrentSince Jun 2, 2024 Accepting new patients
Broadway Oral Surgery, LLC CurrentSince Jun 2, 2024 Accepting new patients
Oral & Maxillofacial Surgery Institute PC Oral and Maxillofacial Surgery Past Accepting new patients
Garden State Oral & Maxillofacial Surgery, LLC Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1992791966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023088",
            "telephone_number": "201-858-1400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "925 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023088",
            "telephone_number": "201-858-1400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRIENZO",
        "first_name": "STEVEN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "DI021870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bayonne, NJ

Sources for this page

Verify at the official NPI Registry.