Serajus Salekin Quaderi, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

17788 Issued in NJ

Practice address

10590 Enduring Freedom Dr
Fort Drum, NY 13602-5503

Phone

(315) 772-5567

NPI assigned

Oct 25, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ2 enrollments

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 2

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.

• Inman Dental Care PC

  • Dentist
  • Edison, NJ
  • NPI 1871638783
  NPD (past) Authorized official
• Guthrie Ahc

  dba Usadc Stone-Drum

  • Military/U.S. Coast Guard Outpatient Clinic/Center
  • Fort Drum, NY
  • NPI 1740486091
  NPD (past)

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1144210824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10590 ENDURING FREEDOM DR",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025503",
            "telephone_number": "315-772-5576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10590 ENDURING FREEDOM DR",
            "city": "FORT DRUM",
            "state": "NY",
            "postal_code": "136025503",
            "telephone_number": "315-772-5567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUADERI",
        "first_name": "SERAJUS",
        "middle_name": "SALEKIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "17788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6792103",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ian Nicolas Prins, DMD
• Lisa M Proulx, RN
• Bonita Lynn Pruitt, DDS
• Lorraine Jaconna Pugh, LCSW
• Jin Pyun, M.D.
• Julia Radko
• Justin David Rado, PHYSICIAN ASSISTANT
• Mahbuba Rahman, DDS
• Colette Rajner
• Mehmet Fatih Ramazanoglu, MD

• Dentist in Fort Drum, NY
• Providers in Fort Drum, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2026; 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.