Vaishnavi Ravindran Iyer, BDS, MPH, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI03033300 Issued in NJ

Practice address

1150 Springfield Ave
Irvington, NJ 07111-2441

Phone

(973) 483-1300

NPI assigned

Jun 3, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HBFIAA

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.

• Newark Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
  • NPI 1740345693
  Medicare reassignment NPD
• Newark Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Newark, NJ
  • NPI 1366993586
  NPD

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

{
    "created_epoch": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1316267115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 GARRITY TER",
            "city": "PINE BROOK",
            "state": "NJ",
            "postal_code": "070589640",
            "telephone_number": "661-444-8992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 SPRINGFIELD AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071112441",
            "telephone_number": "973-483-1300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IYER",
        "first_name": "VAISHNAVI",
        "middle_name": "RAVINDRAN",
        "name_prefix": "Dr.",
        "credential": "BDS, MPH, DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-03",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "25004",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI03033300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013793",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212704505",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Irvington Pharmacy LLC
• Irvington Physical Therapy
• Irvington Primary Care LLC
• Callista Ngozi Iwuala, APN-C
• Jennifer Iwudibia, PHARMD
• J'S House
• Jackie Soul Catering LLC
• Bethany I Jackson
• Nichole Jackson, LCSW
• Sherrell Jackson

• General Practice Dentistry in Irvington, NJ
• Providers in Irvington, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.

Verify at the official NPI Registry.