NPIMap

Organization Active NPI

Peb Dental DDS/PA

  • General Practice Dentistry
  • Piscataway, NJ
National Provider Identifier
1437547890
Registry record updated Jan 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0101028295 Issued in NJ
Legal business name
PEB DENTAL DDS/PA
Practice address
155 Stelton Rd
Piscataway, NJ 08854-3251
Phone
(732) 752-1932
Fax
(732) 752-1268
NPI assigned
Jan 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2015

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

Authorized official

Name
Dr. Vijaya Radhakrishna, M.D.
Title
Pediatrician
Phone
(732) 752-1932

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 0101028295 NJ Primary

Addresses

Primary practice location

155 Stelton Rd
Piscataway, NJ 08854-3251

Mailing address

155 Stelton Rd
Piscataway, NJ 08854-3251
Phone (732) 752-1932

National Provider Directory

National Provider Directory
Tax ID family
Peb Dental DDS PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1420588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420588800000",
    "number": "1437547890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 STELTON RD",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088543251",
            "telephone_number": "732-752-1932",
            "fax_number": "732-752-1268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 STELTON RD",
            "city": "PISCATAWAY",
            "state": "NJ",
            "postal_code": "088543251",
            "telephone_number": "732-752-1932",
            "fax_number": "732-752-1268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEB DENTAL DDS/PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-07",
        "last_updated": "2015-01-07",
        "status": "A",
        "authorized_official_last_name": "RADHAKRISHNA",
        "authorized_official_first_name": "VIJAYA",
        "authorized_official_title_or_position": "PEDIATRICIAN",
        "authorized_official_telephone_number": "732-752-1932",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "0101028295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Piscataway, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2015; 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.