NPIMap

Individual provider Active NPI

Steven Emanuel Pavlushkin, DDS

  • General Practice Dentistry
  • Ocean Township, NJ
National Provider Identifier
1114530284
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02944201 Issued in NJ
Practice address
922 Route 35
Ocean Township, NJ 07712
Phone
(848) 217-2029
NPI assigned
Aug 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 25372 FL
General Practice Dentistry 1223G0001X DGD.9729 SC
General Practice Dentistry 1223G0001X 22DI02944201 NJ Primary

Addresses

Primary practice location

922 Route 35
Ocean Township, NJ 07712

Mailing address

55 Buckley Rd
Marlboro, NJ 07746-2108
Phone (732) 690-0794

Other practice location 1

2515 Route 516
Old Bridge, NJ 08857-4605
Phone (732) 607-0909

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

LicenseStateTypeSpecialty
22DI02944201NJMDGeneral Practice Dentistry
DGD.9729SCMDGeneral Practice Dentistry
25372FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pavlushkin Dental LLC General Practice CurrentSince Dec 3, 2023 Accepting new patients
SC Smiles, LLC PastSince Aug 1, 2020 Accepting new patients

Locations

922 Route 35
Ocean, NJ 07712
Phone (848) 217-2029

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1114530284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 BUCKLEY RD",
            "city": "MARLBORO",
            "state": "NJ",
            "postal_code": "077462108",
            "telephone_number": "732-690-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 ROUTE 35",
            "city": "OCEAN TOWNSHIP",
            "state": "NJ",
            "postal_code": "07712",
            "telephone_number": "848-217-2029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2515 Route 516",
            "address_purpose": "LOCATION",
            "city": "Old Bridge",
            "state": "NJ",
            "postal_code": "088574605",
            "country_code": "US",
            "telephone_number": "732-607-0909",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAVLUSHKIN",
        "first_name": "STEVEN",
        "middle_name": "EMANUEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-28",
        "last_updated": "2023-01-18",
        "certification_date": "2020-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "25372",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "DGD.9729",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02944201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean Township, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.