Organization Active NPI

Smile USA for Reconstructive Dentistry

  • Prosthodontics
  • Elizabeth, NJ
National Provider Identifier
1033383740
Registry record updated Apr 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
19245 Issued in NJ
Legal business name
SMILE USA FOR RECONSTRUCTIVE DENTISTRY
Practice address
469 Morris Ave
Ste. 300
Elizabeth, NJ 07208-1967
Phone
(908) 527-8880
Fax
(908) 527-8587
NPI assigned
Apr 15, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Shankar Iyer, DDS MDS
Title
President
Phone
(908) 527-8880

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 1020481 NJ
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X 19245 NJ Primary

Addresses

Primary practice location

469 Morris Ave
Ste. 300
Elizabeth, NJ 07208-1967

Mailing address

469 Morris Ave Ste 300
Elizabeth, NJ 07208-1967
Phone (908) 527-8880

Other identifiers 1

IdentifierTypeStateIssuer
7221509MedicaidNJ

National Provider Directory

National Provider Directory

Locations

469 Morris Ave
Ste 300
Elizabeth, NJ 07208
Phone (908) 527-8880

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208217600000",
    "number": "1033383740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "469 MORRIS AVE STE 300",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081967",
            "telephone_number": "908-527-8880",
            "fax_number": "908-527-8587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 MORRIS AVE",
            "address_2": "STE. 300",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072081967",
            "telephone_number": "908-527-8880",
            "fax_number": "908-527-8587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMILE USA FOR RECONSTRUCTIVE DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A",
        "authorized_official_last_name": "IYER",
        "authorized_official_first_name": "SHANKAR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-527-8880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS  MDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "1020481",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": "NJ",
            "license": "19245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7221509",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.