Individual provider Active NPI

Sheldon Waltuch, DMD, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Edison, NJ
National Provider Identifier
1336395854
Registry record updated Aug 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
22D101355600 Issued in NJ
Practice address
3 State Highway 27
Colonial Village Professioal BLDG. Suite204
Edison, NJ 08820
Phone
(732) 549-6286
Fax
(732) 549-5282
NPI assigned
Aug 15, 2008
Last updated
Aug 15, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 22D101355600 NJ Primary

Addresses

Primary practice location

3 State Highway 27
Colonial Village Professioal BLDG. Suite204
Edison, NJ 08820

Mailing address

3 State Highway 27
Colonial Village Professional Building
Edison, NJ 08820
Phone (732) 549-6286

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
22D101355600NJMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sheldon Waltuch Orthodontics LLC CurrentSince Nov 27, 2022 Accepting new patients
Sheldon Waltuch DMD, Ms Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Locations

3 Route 27
Ste 204
Edison, NJ 08820
Phone (732) 549-6286

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": "1218758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218758400000",
    "number": "1336395854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 STATE HIGHWAY 27",
            "address_2": "COLONIAL VILLAGE PROFESSIONAL BUILDING",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "08820",
            "telephone_number": "732-549-6286",
            "fax_number": "732-549-5282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 STATE HIGHWAY 27",
            "address_2": "COLONIAL VILLAGE PROFESSIOAL BLDG. SUITE204",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "08820",
            "telephone_number": "732-549-6286",
            "fax_number": "732-549-5282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTUCH",
        "first_name": "SHELDON",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-08-15",
        "last_updated": "2008-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "22D101355600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2008; 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.