Lara Elizabeth Hartleben, DMD
Individual provider Active NPI General Practice Dentistry · Ship Bottom, NJ
NPI 1992997696 · NPPES record last updated Aug 16, 2007
Key facts
- NPI
- 1992997696
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 22DI02107800 (NJ)
- Practice address
- 1815 Long Beach Blvd
Ship Bottom, NJ 08008-4444 - Phone
- (609) 361-0009
- NPI assigned
- Aug 16, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02107800 | NJ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Addiego Family Dental LLC | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22DI02107800 | NJ | Yes |
Addresses
Primary practice location
1815 Long Beach Blvd
Ship Bottom, NJ 08008-4444
Mailing address
810 Barnegat Ave Ste a
Ship Bottom, NJ 08008-4686
Other providers in Ship Bottom, NJ
- Joseph Patrick Clancy Jr.
- Freddie J Davis
- Dena Elizabeth Douglas
- Keri Fedullo
- Robert E Gleason
- Jaclyn Hoffman
- Island Dental , LLC
- Island Medical PA
- Island Medical Professional Association
- J and H Genesis ,LLC
All providers in Ship Bottom, 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 Aug 16, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.