Gopi Surti, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

22DI02798000 Issued in NJ

Practice address

725 River Rd Ste 204a
Edgewater, NJ 07020-1149

Phone

(201) 228-9567

NPI assigned

May 31, 2018

Last updated

Oct 20, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kids & Family Dentistry

  • Dental Clinic/Center
  • Livingston, NJ
  • NPI 1275239295
  NPD (past)

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1104318500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 SANDRA DR",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060428231",
            "telephone_number": "860-803-6385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 RIVER RD STE 204A",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201149",
            "telephone_number": "201-228-9567"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "471 W Mount Pleasant Ave",
            "address_purpose": "LOCATION",
            "city": "Livingston",
            "state": "NJ",
            "postal_code": "070391720",
            "country_code": "US",
            "telephone_number": "973-597-1818",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "180 N Dean St Ste 1",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "NJ",
            "postal_code": "076312534",
            "country_code": "US",
            "telephone_number": "201-569-5437",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Brookdale Plz",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112123139",
            "country_code": "US",
            "telephone_number": "718-240-6552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SURTI",
        "first_name": "GOPI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-31",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02798000",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Dentistry in Edgewater, NJ
• Providers in Edgewater, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.