Individual provider Active NPI

Jennifer Ruth Siller, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Ridgewood, NJ
National Provider Identifier
1376865667
Registry record updated Feb 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
22DI02426700 Issued in NJ
Practice address
182 Franklin Ave
Ridgewood, NJ 07450-3206
Phone
(201) 444-1712
NPI assigned
Feb 27, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 22DI02426700 NJ Primary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 054385 NY

Addresses

Primary practice location

182 Franklin Ave
Ridgewood, NJ 07450-3206

Mailing address

55 E 86TH St
Apartment 4C
New York, NY 10028-1059
Phone (646) 924-8555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22DI02426700NJMDOrthodontics and Dentofacial Orthopedic Dentist
054385NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1267228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1267228800000",
    "number": "1376865667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E 86TH ST",
            "address_2": "APARTMENT 4C",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100281059",
            "telephone_number": "646-924-8555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "182 FRANKLIN AVE",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074503206",
            "telephone_number": "201-444-1712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILLER",
        "first_name": "JENNIFER",
        "middle_name": "RUTH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-27",
        "last_updated": "2010-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "22DI02426700",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "054385",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgewood, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2010; 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.