Shimli Basuroychowdhury, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

22DI02268600 Issued in NJ

Practice address

855 Springfield Ave
Irvington, NJ 07111-3611

Phone

(973) 373-3456

NPI assigned

Sep 9, 2008

Last updated

Sep 9, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Nov 24, 2015 through Nov 24, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Irvington Family Dental LLC

  • General Practice Dentistry
  • Irvington, NJ
  • NPI 1932215969
  NPD (past)
• Irvington Family Dentistry, PA

  • Dentist
  • Irvington, NJ
  • NPI 1245865518
  NPD (past)

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

{
    "created_epoch": "1220918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220918400000",
    "number": "1447409958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "589 WOOD AVE",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088202304",
            "telephone_number": "732-662-7829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 SPRINGFIELD AVE",
            "city": "IRVINGTON",
            "state": "NJ",
            "postal_code": "071113611",
            "telephone_number": "973-373-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASUROYCHOWDHURY",
        "first_name": "SHIMLI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-09",
        "last_updated": "2008-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02268600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dorcas B Ayodele, RN
• Nudrat F Ayub, M.D
• Back on Track Counseling LLC
• Fatu Bangura
• Samuel A Banigo, M.D.,
• Kathlyn Ann Battle, EDD, MSW, LCSW
• Suresh G Belani, M.D.
• Claudine Belford
• Erica Belzince, MA
• Benjis Dad Transportation

• General Practice Dentistry in Irvington, NJ
• Providers in Irvington, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.