Active NPI
Kenneth James
- Dentist
- Newark, NJ
National Provider Identifier
1063524551
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22D102154500
- Practice address
- 101 Ludlow St
Newark, NJ 07114-1108 - Phone
- (973) 565-0355
- Fax
- (973) 565-0461
- NPI assigned
- Aug 31, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 22D102154500 | NJ | Primary |
Addresses
Primary practice location
101 Ludlow St
Newark, NJ 07114-1108
Mailing address
1700 Myrtle Ave
Plainfield, NJ 07063-1000
Phone (908) 753-6401
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194996645 | Other | NJ | 444 WILLIAM STREET |
| 1740345693 | Other | NJ | 741 BROADWAY |
| 1972778413 | Other | NJ | 1150 SPRINGFIELD AVE |
| 8727309 | Medicaid | NJ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22D102154500 | NJ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1063524551",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 MYRTLE AVE",
"city": "PLAINFIELD",
"state": "NJ",
"postal_code": "070631000",
"telephone_number": "908-753-6401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 LUDLOW ST",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071141108",
"telephone_number": "973-565-0355",
"fax_number": "973-565-0461"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMES",
"first_name": "KENNETH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22D102154500",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "444 WILLIAM STREET",
"identifier": "1194996645",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "741 BROADWAY",
"identifier": "1740345693",
"state": "NJ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "1150 SPRINGFIELD AVE",
"identifier": "1972778413",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8727309",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.