Individual provider Active NPI

Jessica Jayne Joseph, DMD

  • General Practice Dentistry
  • Montclair, NJ
National Provider Identifier
1255729083
Registry record updated Jan 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02571800 Issued in NJ
Practice address
177 Gordonhurst Ave
Montclair, NJ 07043-1722
Phone
(973) 744-3181
NPI assigned
Jan 1, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22DI02571800 NJ Primary

Addresses

Primary practice location

177 Gordonhurst Ave
Montclair, NJ 07043-1722

Mailing address

1136 Garden St
Apt 2
Hoboken, NJ 07030-4354
Phone (862) 202-9708

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
22DI02571800NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
David Ferguson, DDS, PA General Practice Past Accepting new patients

Organizations & group practices 1

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": "1420070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420070400000",
    "number": "1255729083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 GARDEN ST",
            "address_2": "APT 2",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070304354",
            "telephone_number": "862-202-9708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 GORDONHURST AVE",
            "city": "MONTCLAIR",
            "state": "NJ",
            "postal_code": "070431722",
            "telephone_number": "973-744-3181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "JESSICA",
        "middle_name": "JAYNE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-01",
        "last_updated": "2015-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02571800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montclair, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2015; 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.