Individual provider Active NPI

Cindy Adelstein, DMD, MAGD

  • Dentist
  • Succasunna, NJ
National Provider Identifier
1083630222
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1857139 Issued in MA
Practice address
20 Commerce Blvd
Suite B
Succasunna, NJ 07876-1348
Phone
(973) 584-1066
Fax
(973) 584-6790
NPI assigned
Jul 14, 2006
Last updated
Jan 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1857139 MA Primary
General Practice Dentistry 1223G0001X 17387 NJ

Addresses

Primary practice location

20 Commerce Blvd
Suite B
Succasunna, NJ 07876-1348

Mailing address

258 Main St Ste C1
Buzzards Bay, MA 02532-3253
Phone (508) 759-2721

Other identifiers 2

IdentifierTypeStateIssuer
1857139OtherMASTATE LICENSE
NJ17387OtherNJSTATE LICENSE

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
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
1857139MAMDDentist
17387NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Canal Side Family Dental Care, Inc. General Practice PastSince Jan 22, 2023 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1083630222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 MAIN ST STE C1",
            "city": "BUZZARDS BAY",
            "state": "MA",
            "postal_code": "025323253",
            "telephone_number": "508-759-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 COMMERCE BLVD",
            "address_2": "SUITE B",
            "city": "SUCCASUNNA",
            "state": "NJ",
            "postal_code": "078761348",
            "telephone_number": "973-584-1066",
            "fax_number": "973-584-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADELSTEIN",
        "first_name": "CINDY",
        "name_prefix": "Dr.",
        "credential": "DMD, MAGD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "1857139",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "17387",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1857139",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "NJ17387",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Succasunna, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.

Verify at the official NPI Registry.