Provider Demographics
NPI:1407068679
Name:JAMES P. MCMENAMIN,D.M.D.,P.A
Entity Type:Organization
Organization Name:JAMES P. MCMENAMIN,D.M.D.,P.A
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORAL SURGEON
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:MCMENAMIN
Authorized Official - Suffix:I
Authorized Official - Credentials:DMD
Authorized Official - Phone:908-757-3231
Mailing Address - Street 1:1024 PARK AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:PLAINFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07060-3026
Mailing Address - Country:US
Mailing Address - Phone:908-757-3231
Mailing Address - Fax:908-756-0792
Practice Address - Street 1:1024 PARK AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-3026
Practice Address - Country:US
Practice Address - Phone:908-757-3231
Practice Address - Fax:908-756-0792
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ139041223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ532536Medicare ID - Type Unspecified