Sheldon Rudnicki, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

09965 Issued in NJ

Practice address

215 Old Tappan Rd
2ND Floor
Old Tappan, NJ 07675-7000

Phone

(201) 666-8811

Fax

(201) 666-8844

NPI assigned

Apr 23, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225256118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 OLD TAPPAN RD",
            "address_2": "2ND FLOOR",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "076757000",
            "telephone_number": "201-666-8811",
            "fax_number": "201-666-8844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 OLD TAPPAN RD",
            "address_2": "2ND FLOOR",
            "city": "OLD TAPPAN",
            "state": "NJ",
            "postal_code": "076757000",
            "telephone_number": "201-666-8811",
            "fax_number": "201-666-8844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDNICKI",
        "first_name": "SHELDON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "09965",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "028152",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Purwin, LCSW
• Jaimee Rizzo, BCBA
• Sang Ro, D.D.S.
• Nancy A Rothenberg, DO
• Alyse Rudnicki, D.D.S., M.S.
• Osvaldo Sanchez
• Sang Yun Ro, DDS, PC (Apex Endodontics)
• Diane C Schwartz, MD
• Robin Helene Semegran, O.D.
• Sensory Diagnostics and Pain Management Associates

• Dentist in Old Tappan, NJ
• Providers in Old Tappan, NJ by specialty
• Dentist in New Jersey

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.