Provider Demographics
NPI:1982940557
Name:HEINOWITZ, RICHARD J (DDS)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:J
Last Name:HEINOWITZ
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 1:345 UNION HILL RD
Mailing Address - Street 2:SUITE G-H
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-1875
Mailing Address - Country:US
Mailing Address - Phone:732-972-0919
Mailing Address - Fax:732-972-0301
Practice Address - Street 1:345 UNION HILL RD
Practice Address - Street 2:SUITE G-H
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-1875
Practice Address - Country:US
Practice Address - Phone:732-972-0919
Practice Address - Fax:732-972-0301
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-29
Last Update Date:2012-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI01208800122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist