Provider Demographics
NPI:1639236490
Name:MACAPODI, MUSA P (DDS)
Entity Type:Individual
Prefix:DR
First Name:MUSA
Middle Name:P
Last Name:MACAPODI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 MALLORY AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07304-1256
Mailing Address - Country:US
Mailing Address - Phone:201-332-3358
Mailing Address - Fax:201-332-4002
Practice Address - Street 1:223 MALLORY AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07304-1256
Practice Address - Country:US
Practice Address - Phone:201-332-3358
Practice Address - Fax:201-332-4002
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJD10189501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice