Individual provider Active NPI

Cristina Michelle Kavendek, DMD

  • General Practice Dentistry
  • Tinton Falls, NJ
National Provider Identifier
1265836746
Registry record updated Oct 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02578300 Issued in NJ
Practice address
15 Columbia Dr
Tinton Falls, NJ 07724-9714
Phone
(908) 601-2834
NPI assigned
Oct 13, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2014

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 22DI02578300 NJ Primary

Addresses

Primary practice location

15 Columbia Dr
Tinton Falls, NJ 07724-9714

Mailing address

15 Columbia Dr
Tinton Falls, NJ 07724-9714
Phone (908) 601-2834

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
22DI02578300NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413158400000",
    "number": "1265836746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 COLUMBIA DR",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077249714",
            "telephone_number": "908-601-2834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 COLUMBIA DR",
            "city": "TINTON FALLS",
            "state": "NJ",
            "postal_code": "077249714",
            "telephone_number": "908-601-2834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAVENDEK",
        "first_name": "CRISTINA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-13",
        "last_updated": "2014-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02578300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinton Falls, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2014; 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.