Active NPI
Johnathan Peter Velardi
- Dentist
- Montclair, NJ
National Provider Identifier
1104192863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22DI02518201
- Practice address
- 1 Bay Ave
Montclair, NJ 07042-4837 - Phone
- (973) 429-6037
- Fax
- (973) 680-7809
- NPI assigned
- Mar 28, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 Acute Care Hospital | 282N00000X | |||
| Dentist | 122300000X | 22DI02518201 | NJ | Primary |
Addresses
Primary practice location
1 Bay Ave
Montclair, NJ 07042-4837
Mailing address
175 Biltmore St
North Arlington, NJ 07031-5609
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 |
|---|---|---|---|
| 22DI02518201 | NJ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332892800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465516800000",
"number": "1104192863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 BILTMORE ST",
"city": "NORTH ARLINGTON",
"state": "NJ",
"postal_code": "070315609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 BAY AVE",
"city": "MONTCLAIR",
"state": "NJ",
"postal_code": "070424837",
"telephone_number": "973-429-6037",
"fax_number": "973-680-7809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VELARDI",
"first_name": "JOHNATHAN",
"middle_name": "PETER",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-03-28",
"last_updated": "2016-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "282N00000X",
"taxonomy_group": "",
"desc": "General Acute Care Hospital",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22DI02518201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Montclair, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.