Provider Demographics
NPI:1255341731
Name:THOMAN, NEIL ALAN (DMD)
Entity type:Individual
Prefix:DR
First Name:NEIL
Middle Name:ALAN
Last Name:THOMAN
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 1:1250 E RIDGEWOOD AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-3956
Mailing Address - Country:US
Mailing Address - Phone:201-445-4452
Mailing Address - Fax:201-445-4453
Practice Address - Street 1:1250 E RIDGEWOOD AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3956
Practice Address - Country:US
Practice Address - Phone:201-445-4452
Practice Address - Fax:201-445-4453
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI010909001223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
U24593Medicare UPIN
TH081816Medicare ID - Type Unspecified