Active NPI
Sara Fatima, DDS
- Pediatric Dentistry
- Jersey City, NJ
National Provider Identifier
1073067963
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 22DI02778100
- Practice address
- 414 Grand St Ste 3
Jersey City, NJ 07302-4240 - Phone
- (217) 361-7647
- NPI assigned
- Aug 8, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22DI02778100 | NJ | |
| Pediatric Dentistry | 1223P0221X | 22DI02778100 | NJ | Primary |
Addresses
Primary practice location
414 Grand St Ste 3
Jersey City, NJ 07302-4240
Mailing address
94 Buena Vista Ave
Piscataway, NJ 08854-4861
Phone (217) 361-7647
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788739200000",
"number": "1073067963",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94 BUENA VISTA AVE",
"city": "PISCATAWAY",
"state": "NJ",
"postal_code": "088544861",
"telephone_number": "217-361-7647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "414 GRAND ST STE 3",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073024240",
"telephone_number": "217-361-7647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FATIMA",
"first_name": "SARA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-08-08",
"last_updated": "2026-09-07",
"certification_date": "2026-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "22DI02778100",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NJ",
"license": "22DI02778100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jersey City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.