Healthcare Provider Details
I. General information
NPI: 1144304155
Provider Name (Legal Business Name): MICHAEL KATZ DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/25/2006
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
124 W MERCHANT ST SUITE A
AUDUBON NJ
08106-1424
US
IV. Provider business mailing address
3048 BARBER LN
MIDDLETOWN DE
19709-3249
US
V. Phone/Fax
- Phone: 856-547-9151
- Fax: 856-547-9152
- Phone: 856-904-9475
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 122300000X |
| Taxonomy | Dentist |
| License Number | DS024174L |
| License Number State | PA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 1223G0001X |
| Taxonomy | General Practice Dentistry |
| License Number | 22DI01499502 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: