Individual provider Active NPI

Vita Davydov

  • Dentist
  • Hoboken, NJ
National Provider Identifier
1083576235
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI03117600 Issued in NJ
Practice address
79 Hudson St Ste 201
Hoboken, NJ 07030-5640
Phone
(551) 900-6202
NPI assigned
Nov 25, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI03117600 NJ Primary

Addresses

Primary practice location

79 Hudson St Ste 201
Hoboken, NJ 07030-5640

Mailing address

79 Hudson St Ste 201
Hoboken, NJ 07030-5640

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

LicenseStateTypeSpecialty
22DI03117600NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Ave Dental, LLC Dentist CurrentSince Nov 30, 2025 Accepting new patients

Locations

165 Ocean Ave
Jersey City, NJ 07305
Phone (551) 554-3500

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1764028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1083576235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 HUDSON ST STE 201",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 HUDSON ST STE 201",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305640",
            "telephone_number": "551-900-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVYDOV",
        "first_name": "VITA",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-11-25",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI03117600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoboken, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.

Verify at the official NPI Registry.