Individual provider Active NPI

Ira Sharma, D.D.S.

  • Dentist
  • Old Bridge, NJ
National Provider Identifier
1376852079
Registry record updated Sep 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
054718 Issued in NY
Practice address
87 Diamond LN
Old Bridge, NJ 08857-3318
Phone
(908) 331-3691
NPI assigned
Sep 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 054718 NY Primary

Addresses

Primary practice location

87 Diamond LN
Old Bridge, NJ 08857-3318

Mailing address

87 Diamond LN
Old Bridge, NJ 08857-3318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20150617001783 NY Order and Referring Only - DentistPractitioner - Dentist 7719298710

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1285632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285632000000",
    "number": "1376852079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 DIAMOND LN",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088573318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 DIAMOND LN",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088573318",
            "telephone_number": "908-331-3691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARMA",
        "first_name": "IRA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-28",
        "last_updated": "2010-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "054718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

Verify at the official NPI Registry.