Healthcare Provider Details

I. General information

NPI: 1689694762
Provider Name (Legal Business Name): MICHAEL J BIXBY D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 07/11/2025
Certification Date: 07/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 STATE ROUTE 33 STE 114
NEPTUNE CITY NJ
07753-6121
US

IV. Provider business mailing address

2240 STATE ROUTE 33 STE 114
NEPTUNE CITY NJ
07753-6121
US

V. Phone/Fax

Practice location:
  • Phone: 732-455-3030
  • Fax:
Mailing address:
  • Phone: 732-455-3030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDI 20386
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: