Individual provider Active NPI

Judith Anne Grierden, D.M.D.

  • General Practice Dentistry
  • Berkeley Heights, NJ
National Provider Identifier
1376632646
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
9984 Issued in NJ
Practice address
230 Plainfield Ave
Berkeley Heights, NJ 07922-1462
Phone
(908) 771-9543
NPI assigned
Oct 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9984 NJ Primary

Addresses

Primary practice location

230 Plainfield Ave
Berkeley Heights, NJ 07922-1462

Mailing address

230 Plainfield Ave
Berkeley Heights, NJ 07922-1462
Phone (908) 771-9543

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
I20160427002094 NJ Order and Referring Only - DentistPractitioner - Dentist 5597064402

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9984NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376632646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 PLAINFIELD AVE",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079221462",
            "telephone_number": "908-771-9543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 PLAINFIELD AVE",
            "city": "BERKELEY HEIGHTS",
            "state": "NJ",
            "postal_code": "079221462",
            "telephone_number": "908-771-9543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIERDEN",
        "first_name": "JUDITH",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "9984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley Heights, NJ

Sources for this page

Verify at the official NPI Registry.