Individual provider Active NPI

Ruth Elaine Parkin-Edwin, DMD, MS

  • Periodontics
  • Bloomfield, NJ
National Provider Identifier
1275507162
Registry record updated Feb 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DI20510 Issued in NJ
Practice address
275 Broad St
Bloomfield, NJ 07003-2724
Phone
(973) 743-4743
Fax
(973) 743-4780
NPI assigned
Feb 15, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02051000 NJ
Periodontics 1223P0300X DI20510 NJ Primary

Addresses

Primary practice location

275 Broad St
Bloomfield, NJ 07003-2724

Mailing address

275 Broad St
Bloomfield, NJ 07003-2724
Phone (973) 743-4743

Other practice location 1

15 Freeman Ave
East Orange, NJ 07018-3429
Phone (973) 673-4743

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
I20250416000465 NJ Practitioner - Dentist 1850602533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Other, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

15 Freeman Ave
East Orange, NJ 07018-3429
Phone (973) 673-4743

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
22DI02051000NJMDDentist
DI20510NJMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Irie Dental Spa of the Oranges LLC Dentist Current Accepting new patients
Irie Dental Spa of the Oranges CurrentSince Sep 7, 2011 Accepting new patients

Locations

15 Freeman Ave
East Orange, NJ 07018
Phone (973) 673-4743

200 Metroplex Dr
Edison, NJ 08817
Phone (732) 235-4351

69 1st Ave
Raritan, NJ 08869
Phone (800) 631-5250

Organizations & group practices 2

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": "1139961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1275507162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 BROAD ST",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070032724",
            "telephone_number": "973-743-4743",
            "fax_number": "973-743-4780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 BROAD ST",
            "city": "BLOOMFIELD",
            "state": "NJ",
            "postal_code": "070032724",
            "telephone_number": "973-743-4743",
            "fax_number": "973-743-4780"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Freeman Ave",
            "address_purpose": "LOCATION",
            "city": "East Orange",
            "state": "NJ",
            "postal_code": "070183429",
            "country_code": "US",
            "telephone_number": "973-673-4743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKIN-EDWIN",
        "first_name": "RUTH",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-15",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02051000",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "DI20510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, NJ

Sources for this page

Verify at the official NPI Registry.