Active NPI
David Tarrab, DDS
- Pediatric Dentistry
- Eatontown, NJ
National Provider Identifier
1164802575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DI016930
- Practice address
- 288 Highway 35 S
Suite B
Eatontown, NJ 07724-2174 - Phone
- (732) 389-2422
- NPI assigned
- Jun 2, 2015
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DI016930 | NJ | Primary |
Addresses
Primary practice location
288 Highway 35 S
Suite B
Eatontown, NJ 07724-2174
Mailing address
288 Highway 35 S
Suite B
Eatontown, NJ 07724-2174
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160225000186 | NJ | Order and Referring Only - Oral Surgery | 8224333554 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI016930 | NJ | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433203200000",
"number": "1164802575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "288 HIGHWAY 35 S",
"address_2": "SUITE B",
"city": "EATONTOWN",
"state": "NJ",
"postal_code": "077242174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "288 HIGHWAY 35 S",
"address_2": "SUITE B",
"city": "EATONTOWN",
"state": "NJ",
"postal_code": "077242174",
"telephone_number": "732-389-2422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TARRAB",
"first_name": "DAVID",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-02",
"last_updated": "2015-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NJ",
"license": "DI016930",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eatontown, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2015; 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.