Active NPI
Bertram Strachan Jr.
- Pediatric Dentistry
- Woodbridge, NJ
National Provider Identifier
1093169799
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 059969
- Practice address
- 148 Strawberry Hill Ave
Woodbridge, NJ 07095-2632 - Phone
- (646) 703-3824
- NPI assigned
- Apr 19, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Dentistry | 1223P0221X | 059969 | NY | Primary |
Addresses
Primary practice location
148 Strawberry Hill Ave
Woodbridge, NJ 07095-2632
Mailing address
148 Strawberry Hill Ave
Woodbridge, NJ 07095-2632
Phone (646) 703-3824
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 |
|---|---|---|---|
| 059969 | NY | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1555372800000",
"number": "1093169799",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "148 STRAWBERRY HILL AVE",
"city": "WOODBRIDGE",
"state": "NJ",
"postal_code": "070952632",
"telephone_number": "646-703-3824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "148 STRAWBERRY HILL AVE",
"city": "WOODBRIDGE",
"state": "NJ",
"postal_code": "070952632",
"telephone_number": "646-703-3824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STRACHAN",
"first_name": "BERTRAM",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-04-19",
"last_updated": "2019-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NY",
"license": "059969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woodbridge, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.