Carla Dersarkissian, D.D.S., M.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

#22DI 02188100 Issued in NJ

Practice address

230 W Jersey St
Suite 302
Elizabeth, NJ 07202-1364

Phone

(908) 282-6998

Fax

(908) 282-0306

NPI assigned

Sep 27, 2006

Sex

Female

Sole proprietor

Yes

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

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366533234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 W JERSEY ST",
            "address_2": "SUITE 302",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072021364",
            "telephone_number": "908-282-6998",
            "fax_number": "908-282-0306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W JERSEY ST",
            "address_2": "SUITE 302",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072021364",
            "telephone_number": "908-282-6998",
            "fax_number": "908-282-0306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DERSARKISSIAN",
        "first_name": "CARLA",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NJ",
            "license": "#22DI 02188100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis Bruder Odpa
• Deo Brands LLC (DEO NY Retail 1, LLC)
• Deo Ny Retail 1 LLC (Jersey Garden S Mall)
• Asia Depas
• Lisa M Derr, D.O.
• Nemish Jay Desai, DDS
• Sangeeta Sachinkumar Desai, PHYSICAL THERAPIST
• Twaraa Mandeep Desai, MD
• Chandrashekhar Deshpande
• Bridget Desmarais, PA-C

• Endodontics in Elizabeth, NJ
• Providers in Elizabeth, NJ by specialty
• Endodontics in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.