Dr Theodore A Niebloom, DMD in West Orange, NJ

Dr Theodore A Niebloom, DMD is a medicare enrolled "Dentist - Oral And Maxillofacial Surgery" provider in West Orange, New Jersey. His current practice location is 101 Old Short Hills Road, West Orange, New Jersey. You can reach out to his office (for appointments etc.) via phone at (973) 736-7616.

Dr Theodore A Niebloom is licensed to practice in New Jersey (license number 22DI01604200) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1689750705.

Contact Information

	Dr Theodore A Niebloom, DMD
	101 Old Short Hills Road, West Orange, NJ 07052
	(973) 736-7616
	(973) 325-3487

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Theodore A Niebloom
Gender	Male
Speciality	Dentist - Oral And Maxillofacial Surgery
Location	101 Old Short Hills Road, West Orange, New Jersey
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1689750705
Provider Enumeration Date: 10/31/2006
Last Update Date: 10/05/2016

Medicare PECOS Information:

PECOS PAC ID: 4789719444
Enrollment ID: I20100320000003

Medical Identifiers

Medical identifiers for Dr Theodore A Niebloom such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1689750705	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223S0112X	Dentist - Oral And Maxillofacial Surgery	22DI01604200 (New Jersey)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Theodore A Niebloom allows following entities to bill medicare on his behalf.

Entity Name	Metropolitan Craniofacial Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1306922422 PECOS PAC ID: 3577698224 Enrollment ID: O20100319000175

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Theodore A Niebloom is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Theodore A Niebloom, DMD 101 Old Short Hills Road, West Orange, NJ 07052 Ph: (973) 736-7616	Dr Theodore A Niebloom, DMD 101 Old Short Hills Road, West Orange, NJ 07052 Ph: (973) 736-7616

Reviews and Comments

Dentist in West Orange, NJ

Dr. Kimberly Anne Rosenfeld, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 412 Pleasant Valley Way, West Orange, NJ 07405 Phone: 973-731-2468 Fax: 973-731-2501
Dr. Allan Jeremy Stein, DMD Dentist Medicare: Medicare Enrolled Practice Location: 769 Northfield Ave Ste 154, West Orange, NJ 07052 Phone: 973-736-0111 Fax: 973-325-6442
Dr. Seungwon Yoon, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 412 Pleasant Valley Way Ste 2, West Orange, NJ 07052 Phone: 973-731-2468
Dr. Sandra Onukwugha, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 464 Eagle Rock Ave, West Orange, NJ 07052 Phone: 973-324-9999
Eden Baluyote Vincent, DMD LLC Dentist Medicare: Medicare Enrolled Practice Location: 508 Pleasant Valley Way, West Orange, NJ 07052 Phone: 973-731-0087 Fax: 973-731-0024
Brian Calvin Martin, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 622 Eagle Rock Ave, Suite 105, West Orange, NJ 07052 Phone: 973-325-1011 Fax: 973-325-1183
Dr. Ivan Fredric Stein, DDS Dentist Medicare: May Accept Medicare Assignments Practice Location: 769 Northfield Ave, Suite 154, West Orange, NJ 07052 Phone: 973-736-0111 Fax: 973-325-6442

Dr Theodore A Niebloom, DMD - Medicare Dentist in West Orange, NJ