Individual provider Active NPI

Keith Andrew Abrams, D.M.D.

  • Periodontics
  • Clifton, NJ
National Provider Identifier
1295950863
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
13997 Issued in NJ
Practice address
1100 Clifton Ave
E
Clifton, NJ 07013-3631
Phone
(973) 773-3741
Fax
(973) 778-2068
NPI assigned
Apr 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 13997 NJ Primary

Addresses

Primary practice location

1100 Clifton Ave
E
Clifton, NJ 07013-3631

Mailing address

1100 Clifton Ave
E
Clifton, NJ 07013-3631
Phone (973) 773-3741

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
I20160307000940 NJ Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 6103122809

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13997NJMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295950863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 CLIFTON AVE",
            "address_2": "E",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133631",
            "telephone_number": "973-773-3741",
            "fax_number": "973-778-2068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CLIFTON AVE",
            "address_2": "E",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070133631",
            "telephone_number": "973-773-3741",
            "fax_number": "973-778-2068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABRAMS",
        "first_name": "KEITH",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "NJ",
            "license": "13997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

Verify at the official NPI Registry.