Khadijah Ismael, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02314800 Issued in NJ

Practice address

21 Quitman St
Newark, NJ 07103-4105

Phone

(973) 424-4329

Fax

(973) 824-2097

NPI assigned

Mar 6, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Interoperability endpoints

• Direct secure messaging: khadijah.ismael.2@12521.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Communitopia

  • Clinical Social Worker
  • Edison, NJ
  • NPI 1902250731
  Authorized official Same address or phone
• Central Jersey Medical Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
  • NPI 1124230883
  NPD (past)
• Central Jersey Medical Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Carteret, NJ
  • NPI 1932974250
  NPD (past)
• Central Jersey Medical Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
  • NPI 1710199468
  NPD (past)

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1063542587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 BORMAN AVE",
            "city": "AVENEL",
            "state": "NJ",
            "postal_code": "070012106",
            "telephone_number": "973-979-6144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 QUITMAN ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071034105",
            "telephone_number": "973-424-4329",
            "fax_number": "973-824-2097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ISMAEL",
        "first_name": "KHADIJAH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02314800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0097845",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0097829",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0097837",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christine Isabella
• Dorothy A Isecke, MD
• Maheen Ishaq, D.D.S.
• Yoshihiro Ishikawa, MD
• Mina Nader Iskander
• Khalilah Ismael, MSN, RN, WHNP-BC
• Mohamed Ismail
• Tasha Israel
• Ereiny Issa, RPH
• Zeinah Issah

• General Practice Dentistry in Newark, NJ
• Providers in Newark, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.