Individual provider Active NPI

Jamie Golub

  • Pediatric Dentistry
  • Fort Lee, NJ
National Provider Identifier
1215021373
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
16308 Issued in NJ
Practice address
2185 Lemoine Ave
Suite 1-JJ
Fort Lee, NJ 07024-6036
Phone
(201) 944-7636
Fax
(201) 944-9056
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

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
Pediatric Dentistry 1223P0221X 16308 NJ Primary

Addresses

Primary practice location

2185 Lemoine Ave
Suite 1-JJ
Fort Lee, NJ 07024-6036

Mailing address

2185 Lemoine Ave
Suite 1-JJ
Fort Lee, NJ 07024-6036
Phone (201) 944-7636

Other names 1

  • Prof. Jamie Diament-Golub Professional name

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
16308NJMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215021373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2185 LEMOINE AVE",
            "address_2": "SUITE 1-JJ",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246036",
            "telephone_number": "201-944-7636",
            "fax_number": "201-944-9056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2185 LEMOINE AVE",
            "address_2": "SUITE 1-JJ",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070246036",
            "telephone_number": "201-944-7636",
            "fax_number": "201-944-9056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLUB",
        "first_name": "JAMIE",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "16308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAMIE",
            "last_name": "DIAMENT-GOLUB",
            "prefix": "PROF.",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fort Lee, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.