Alan Valderrama, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02502200 Issued in NJ

Practice address

3538 State Route 27
Kendall Park, NJ 08824-1050

Phone

(732) 821-8585

Fax

(732) 821-1055

NPI assigned

Aug 31, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

State licenses

Practice roles

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.

• Valderrama and Hussain LLC

  • Dental Clinic/Center
  • Kendall Park, NJ
  • NPI 1407371990
  NPD (past) Authorized official
• Long Hill Dental LLC

  • Dentist
  • Gillette, NJ
  • NPI 1093241689
  NPD (past)

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

{
    "created_epoch": "1346371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1104175595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3538 STATE ROUTE 27",
            "city": "KENDALL PARK",
            "state": "NJ",
            "postal_code": "08824",
            "telephone_number": "732-821-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3538 STATE ROUTE 27",
            "city": "KENDALL PARK",
            "state": "NJ",
            "postal_code": "088241050",
            "telephone_number": "732-821-8585",
            "fax_number": "732-821-1055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "671 Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Gillette",
            "state": "NJ",
            "postal_code": "079331919",
            "country_code": "US",
            "telephone_number": "908-580-0870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VALDERRAMA",
        "first_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-31",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02502200",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02502200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Arc Middlesex County
• The Arc Middlesex County
• Meryem Sarah Turan, PA-C
• United Dental Group of Brunswick
• Valderrama and Hussain LLC
• Purnima Vallabhaneni, MD
• Velocity Physical Therapy Services LLC
• Anjali Verner, PTA
• Vinecare LLC
• Vitalcare Medical Equipment LLC

• General Practice Dentistry in Kendall Park, NJ
• Providers in Kendall Park, 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 Mar 17, 2018; 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.