Individual provider Active NPI

Rada Sumareva, DDS

  • Periodontics
  • Ridgefield Park, NJ
National Provider Identifier
1215092200
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
22DI02003400 Issued in NJ
Practice address
45 US Highway 46
Ridgefield Park, NJ 07660-1948
Phone
(201) 440-2100
Fax
(201) 440-1550
NPI assigned
Dec 27, 2006
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
Periodontics 1223P0300X 22DI02003400 NJ Primary

Addresses

Primary practice location

45 US Highway 46
Ridgefield Park, NJ 07660-1948

Mailing address

45 US Highway 46
Ridgefield Park, NJ 07660-1948
Phone (201) 440-2100

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
22DI02003400NJMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Ziphycare Medical of Florida, P.a. Current Accepting new patients
Tristate Physician Services PC Current Accepting new patients
Ziphycare Medical of New Jersey PC Current Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215092200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 US HIGHWAY 46",
            "city": "RIDGEFIELD PARK",
            "state": "NJ",
            "postal_code": "076601948",
            "telephone_number": "201-440-2100",
            "fax_number": "201-440-1550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 US HIGHWAY 46",
            "city": "RIDGEFIELD PARK",
            "state": "NJ",
            "postal_code": "076601948",
            "telephone_number": "201-440-2100",
            "fax_number": "201-440-1550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMAREVA",
        "first_name": "RADA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "22DI02003400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgefield Park, 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.