Active NPI
Anil Purshotam Ardeshna, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Newark, NJ
National Provider Identifier
1427034966
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DI01783700
- Practice address
- 110 Bergen Street
Umdnj-New Jersey Dental School- Room
Newark, NJ 07103-2495 - Phone
- (973) 972-4729
- Fax
- (973) 972-0526
- NPI assigned
- Dec 16, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DI01783700 | NJ | Primary |
Addresses
Primary practice location
110 Bergen Street
Umdnj-New Jersey Dental School- Room
Newark, NJ 07103-2495
Mailing address
110 Bergen Street, Room 712C
Umdnj-New Jersey Dental
Newark, NJ 07103
Phone (973) 972-1892
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150624000656 | NJ | Order and Referring Only - Dentist | 3274844881 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI01783700 | NJ | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1134691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1226966400000",
"number": "1427034966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 BERGEN STREET, ROOM 712C",
"address_2": "UMDNJ-NEW JERSEY DENTAL",
"city": "NEWARK",
"state": "NJ",
"postal_code": "07103",
"telephone_number": "973-972-1892",
"fax_number": "973-972-0526"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 BERGEN STREET",
"address_2": "UMDNJ-NEW JERSEY DENTAL SCHOOL- ROOM",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071032495",
"telephone_number": "973-972-4729",
"fax_number": "973-972-0526"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ARDESHNA",
"first_name": "ANIL",
"middle_name": "PURSHOTAM",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-16",
"last_updated": "2008-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NJ",
"license": "DI01783700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.