Individual provider Active NPI

Nezhat Razeghi, DDS

  • Dentist
  • Jersey City, NJ
National Provider Identifier
1356441224
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2201017152 Issued in NJ
Practice address
714 Bergen Ave
Jersey City, NJ 07306-4802
Phone
(201) 683-2424
Fax
(201) 654-0752
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2201017152 NJ Primary

Addresses

Primary practice location

714 Bergen Ave
Jersey City, NJ 07306-4802

Mailing address

714 Bergen Ave
Jersey City, NJ 07306-4802
Phone (201) 683-2424

Other identifiers 1

IdentifierTypeStateIssuer
0028401MedicaidNJ

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
I20161005001087 NJ Order and Referring Only - Other (Physician)Practitioner - Other (Physician) 2567750672

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2201017152NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1356441224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 BERGEN AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064802",
            "telephone_number": "201-683-2424",
            "fax_number": "201-654-0752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 BERGEN AVE",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064802",
            "telephone_number": "201-683-2424",
            "fax_number": "201-654-0752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAZEGHI",
        "first_name": "NEZHAT",
        "name_prefix": "Mrs.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "2201017152",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0028401",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.