Active NPI
Adam Andrew Fernandes, DDS, DOCTOR OF DENTA
- General Practice Dentistry
- Newark, NJ
National Provider Identifier
1245877521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 220102851600
- Practice address
- 9-25 Alling Street
Newark, NJ 07102 - Phone
- (973) 297-1550
- NPI assigned
- Dec 5, 2019
- Reactivated
- Sep 14, 2021
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 220102851600 | NJ | Primary |
Addresses
Primary practice location
9-25 Alling Street
Newark, NJ 07102
Mailing address
601 West 57TH Street
Apartment 7a
New York City, NY 10019
Phone (718) 902-8302
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
| License | State | Type | Specialty |
|---|---|---|---|
| 220102851600 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631577600000",
"number": "1245877521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 WEST 57TH STREET",
"address_2": "APARTMENT 7A",
"city": "NEW YORK CITY",
"state": "NY",
"postal_code": "10019",
"telephone_number": "718-902-8302"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9-25 ALLING STREET",
"city": "NEWARK",
"state": "NJ",
"postal_code": "07102",
"telephone_number": "973-297-1550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FERNANDES",
"first_name": "ADAM",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "DDS, DOCTOR OF DENTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-12-05",
"last_updated": "2021-09-14",
"certification_date": "2021-09-14",
"deactivation_date": "2020-12-08",
"reactivation_date": "2021-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "220102851600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.