Individual provider Active NPI

Dena Constandelis

  • General Practice Dentistry
  • Clifton, NJ
National Provider Identifier
1265743439
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02448000 Issued in NJ
Practice address
465 Valley Rd
Clifton, NJ 07013-2234
Phone
(973) 684-1078
NPI assigned
Jun 23, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

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 22DI02448000 NJ Primary

Addresses

Primary practice location

465 Valley Rd
Clifton, NJ 07013-2234

Mailing address

48 Abbott Rd
Towaco, NJ 07082-1252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20160303000939 NJ Order and Referring Only - DentistPractitioner - Dentist 8426354309

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Theodore N Constandelis 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": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315267200000",
    "number": "1265743439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48 ABBOTT RD",
            "city": "TOWACO",
            "state": "NJ",
            "postal_code": "070821252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 VALLEY RD",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132234",
            "telephone_number": "973-684-1078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONSTANDELIS",
        "first_name": "DENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-23",
        "last_updated": "2011-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02448000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.