Individual provider Active NPI

Elba Catalina Ventura, DENTIST DDS

  • Dentist
  • Harrison, NJ
National Provider Identifier
1447461702
Registry record updated Jan 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DI20672 Issued in NJ
Practice address
105A-107 Frank E Rodgers Blvd N
Harrison, NJ 07029
Phone
(973) 350-9800
Fax
(973) 350-0450
NPI assigned
May 25, 2007
Last updated
Jan 11, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DI20672 NJ Primary

Addresses

Primary practice location

105A-107 Frank E Rodgers Blvd N
Harrison, NJ 07029

Mailing address

105A-107 Frank E Rodgers Blvd N
Harrison, NJ 07029
Phone (973) 350-9800

Other identifiers 1

IdentifierTypeStateIssuer
8286906MedicaidNJ

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
DI20672NJMDDentist

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357862400000",
    "number": "1447461702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105A-107 FRANK E RODGERS BLVD N",
            "city": "HARRISON",
            "state": "NJ",
            "postal_code": "07029",
            "telephone_number": "973-350-9800",
            "fax_number": "973-350-0450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105A-107 FRANK E RODGERS BLVD N",
            "city": "HARRISON",
            "state": "NJ",
            "postal_code": "07029",
            "telephone_number": "973-350-9800",
            "fax_number": "973-350-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTURA",
        "first_name": "ELBA",
        "middle_name": "CATALINA",
        "name_prefix": "Mrs.",
        "credential": "DENTIST DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2013-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "DI20672",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8286906",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harrison, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2013; 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.