Fariba Edalat, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DI22496 Issued in NJ

Practice address

639 Mount Prospect Ave
Newark, NJ 07104-3109

Phone

(973) 481-3900

Fax

(973) 481-2999

NPI assigned

Feb 17, 2010

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• All City Dental Services

  • General Practice Dentistry
  • Newark, NJ
  • NPI 1487879128
  NPD (past)

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

{
    "created_epoch": "1266364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346889600000",
    "number": "1366764474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 SCHINDLER TER",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070521079",
            "telephone_number": "973-736-0642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "639 MOUNT PROSPECT AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071043109",
            "telephone_number": "973-481-3900",
            "fax_number": "973-481-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDALAT",
        "first_name": "FARIBA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-17",
        "last_updated": "2012-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI22496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0233552",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abrar Ebady, MD
• Jessica Ebegbulem, LAC
• Saman Ebrahimzadeh
• Nikolas Bustamante Echeverry, MD
• Eckerd Corporation
• Husham A Edani, DENTIST
• Osamuede Folorunsho Edobor-Osula, M.D.
• Izevbuwa O. Edokpolor
• Obunike O Edokwe, MD
• Cassandra Edouard, LCSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; 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.