Active NPI
Dipti A Modi, DDS
- Dentist
- South Amboy, NJ
National Provider Identifier
1306989900
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DI 018381
- Practice address
- 441 Gordon St
South Amboy, NJ 08879-1513 - Phone
- (732) 727-0474
- Fax
- (732) 727-1026
- NPI assigned
- Feb 14, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DI 018381 | NJ | Primary |
Addresses
Primary practice location
441 Gordon St
South Amboy, NJ 08879-1513
Mailing address
441 Gordon St
South Amboy, NJ 08879-1513
Phone (732) 727-0474
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160309001596 | NJ | Order and Referring Only - Dentist | 9335445824 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI 018381 | NJ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306989900",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "441 GORDON ST",
"city": "SOUTH AMBOY",
"state": "NJ",
"postal_code": "088791513",
"telephone_number": "732-727-0474",
"fax_number": "732-727-1026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "441 GORDON ST",
"city": "SOUTH AMBOY",
"state": "NJ",
"postal_code": "088791513",
"telephone_number": "732-727-0474",
"fax_number": "732-727-1026"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODI",
"first_name": "DIPTI",
"middle_name": "A",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "DI 018381",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Amboy, NJ
- Metropolitan Surgical Institute, LLC
- MGT Physical Therapy LLC
- Mid Jersey Resp. Associates, Medical Supplies & Clinical SVCS., Inc
- Middlesex Community Health Center Inc
- Mobile Life Support Services . Inc
- Koral A Modi, DMD
- Rumantha Moody, M.D.
- Keeshia Garcia Mora, LPN
- Amber Morgan, LPC, SAC, MA
- Alan Morgenstern, D.M.D
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.