Active NPI
Divya Jain
- Dentist
- Avenel, NJ
National Provider Identifier
1467195156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22DI02915700
- Practice address
- 1030 Saint Georges Ave
Avenel, NJ 07001-1390 - Phone
- (732) 910-7286
- NPI assigned
- Apr 19, 2022
- Last updated
- Jul 26, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 22DI02915700 | NJ | Primary |
Addresses
Primary practice location
1030 Saint Georges Ave
Avenel, NJ 07001-1390
Mailing address
30 Waterside PLZ Apt 12G
New York, NY 10010-2644
Phone (732) 910-7286
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02915700 | NJ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658793600000",
"number": "1467195156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 WATERSIDE PLZ APT 12G",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100102644",
"telephone_number": "732-910-7286"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 SAINT GEORGES AVE",
"city": "AVENEL",
"state": "NJ",
"postal_code": "070011390",
"telephone_number": "732-910-7286"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAIN",
"first_name": "DIVYA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-19",
"last_updated": "2022-07-26",
"certification_date": "2022-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22DI02915700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Avenel, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.