Active NPI
Suzan Ghattas, DMD
- General Practice Dentistry
- Irvington, NJ
National Provider Identifier
1144497660
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DI021637
- Practice address
- 961 Sanford Ave
Irvington, NJ 07111-1421 - Phone
- (973) 372-2330
- Fax
- (973) 375-4865
- NPI assigned
- May 14, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DI021637 | NJ | Primary |
Addresses
Primary practice location
961 Sanford Ave
Irvington, NJ 07111-1421
Mailing address
961 Sanford Ave
Irvington, NJ 07111-1421
Phone (973) 372-2330
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 |
|---|---|---|---|
| DI021637 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210723200000",
"number": "1144497660",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "961 SANFORD AVE",
"city": "IRVINGTON",
"state": "NJ",
"postal_code": "071111421",
"telephone_number": "973-372-2330",
"fax_number": "973-375-4865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "961 SANFORD AVE",
"city": "IRVINGTON",
"state": "NJ",
"postal_code": "071111421",
"telephone_number": "973-372-2330",
"fax_number": "973-375-4865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHATTAS",
"first_name": "SUZAN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-14",
"last_updated": "2008-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "DI021637",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Irvington, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.