Supraja Chakravarthi Badri, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02859900 Issued in NJ

Practice address

32 Clinton St
Paterson, NJ 07522-1775

Phone

(973) 790-6594

NPI assigned

Oct 5, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1633392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1366114506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5302 RIVERSIDE STATION BLVD",
            "city": "SECAUCUS",
            "state": "NJ",
            "postal_code": "070944453",
            "telephone_number": "201-478-0052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 CLINTON ST",
            "city": "PATERSON",
            "state": "NJ",
            "postal_code": "075221775",
            "telephone_number": "973-790-6594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADRI",
        "first_name": "SUPRAJA",
        "middle_name": "CHAKRAVARTHI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-05",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02859900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Justina Babu, M.D.
• Mark Badach, MD
• Walid Baddoura, M.D.
• Rami Bader, PHARM D.
• Suzanne Bader
• Yasmine Baglieri
• Ramazan Bahar, APN
• Iqra Fatima Baig, MD, MSC
• Kalavathy Balakumar, MD
• Peter Balazs, M.D.

• Dentist in Paterson, NJ
• Providers in Paterson, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2021; 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.