Individual provider Active NPI

Jason Nudelman, DDS

  • Pediatric Dentistry
  • East Brunswick, NJ
National Provider Identifier
1336294412
Registry record updated Nov 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
22DI02298700 Issued in NJ
Practice address
17 Brunswick Woods Drive
East Brunswick, NJ 08816
Phone
(732) 238-0792
Fax
(732) 238-0792
NPI assigned
Jan 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 22DI02298700 NJ Primary

Addresses

Primary practice location

17 Brunswick Woods Drive
East Brunswick, NJ 08816

Mailing address

17 Brunswick Woods Drive
East Brunswick, NJ 08816
Phone (732) 238-5100

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
22DI02298700NJMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Jeffrey S. Karlin, P.a. Past Accepting new patients
Jason Nudelman, DDS PC Pediatric Dentistry PastSince Aug 15, 2021 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289520000000",
    "number": "1336294412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 BRUNSWICK WOODS DRIVE",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "08816",
            "telephone_number": "732-238-5100",
            "fax_number": "732-238-0792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 BRUNSWICK WOODS DRIVE",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "08816",
            "telephone_number": "732-238-0792",
            "fax_number": "732-238-0792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUDELMAN",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-25",
        "last_updated": "2010-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02298700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2010; 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.