Provider Demographics
NPI:1568439099
Name:NAVILIO, ANTHONY (DMD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:
Last Name:NAVILIO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 ROUTE 72 W STE 204
Mailing Address - Street 2:
Mailing Address - City:MANAHAWKIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08050-2486
Mailing Address - Country:US
Mailing Address - Phone:609-978-1300
Mailing Address - Fax:609-978-5550
Practice Address - Street 1:1322 ROUTE 72 W STE 204
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2486
Practice Address - Country:US
Practice Address - Phone:609-978-1300
Practice Address - Fax:609-978-5550
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-03
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI178091223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU68665Medicare UPIN
NJ001349Medicare ID - Type UnspecifiedMEDICARE NUMBER