GARY BROUSELL D.D.S.PA NPI 1760520670

NPI Information

  • NPI: 1760520670
  • Provider Name: GARY BROUSELL, D.D.S.PA
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Address: 21 GILBERT ST.
    TINTON FALL, NJ
    ZIP 07724
  • Phone: (732) 747-0993

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NPI Details

GARY BROUSELL, D.D.S.PA is an oral and maxillofacial surgery dentist in Tinton Fall, NJ. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. GARY BROUSELL, D.D.S.PA NPI is 1760520670. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

21 GILBERT ST.
TINTON FALL, NJ
ZIP 07724
Phone: (732) 747-0993
Fax: (732) 747-0961

The provider's authorized official is Gary M Brousell .
The authorized official title is President and has the following contact phone number (732) 747-0993.

The enumeration date for this NPI number is 2/2/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223S0112XDentistOral and Maxillofacial SurgeryDI10690NEW JERSEYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11863401MEDICAIDNEW JERSEY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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