Individual provider Active NPI

Shalini Tewary, DMD

  • Dentist
  • Hawthorne, NJ
National Provider Identifier
1184762924
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22D102250101 Issued in NJ
Practice address
164 Warburton Avenue
Hawthorne, NJ 07506
Phone
(973) 427-4201
Fax
(973) 427-3480
NPI assigned
Feb 2, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22D102250101 NJ Primary

Addresses

Primary practice location

164 Warburton Avenue
Hawthorne, NJ 07506

Mailing address

164 Warburton Avenue
Hawthorne, NJ 07506
Phone (973) 427-4201

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110701000135 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9234317769

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22D102250101NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Anthony M Pallotta DDS PA Dentist Past Accepting new patients
Adam Rauzman D.D.S. Dentist Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184762924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 WARBURTON AVENUE",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "07506",
            "telephone_number": "973-427-4201",
            "fax_number": "973-427-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 WARBURTON AVENUE",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "07506",
            "telephone_number": "973-427-4201",
            "fax_number": "973-427-3480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEWARY",
        "first_name": "SHALINI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22D102250101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hawthorne, NJ

Sources for this page

Verify at the official NPI Registry.