Active NPI
Aws Daraldik
- Dentist
- Clifton, NJ
National Provider Identifier
1477281749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22DI02913100
- Practice address
- 1053 Bloomfield Ave Ste 14
Clifton, NJ 07012-2120 - Phone
- (973) 932-4422
- NPI assigned
- Aug 12, 2022
- Last updated
- Aug 12, 2022
- Sex
- Male
- Sole proprietor
- Yes
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 | 22DI02913100 | NJ | Primary |
Addresses
Primary practice location
1053 Bloomfield Ave Ste 14
Clifton, NJ 07012-2120
Mailing address
187 Hadley Ave
Clifton, NJ 07011-3371
Phone (973) 932-4422
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 |
|---|---|---|---|
| 22DI02913100 | NJ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saddle Brook Radiance | Current | Accepting new patients |
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.
-
dba Radiance Dental
- General Practice Dentistry
- Saddle Brook, NJ
- NPI 1457214868
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1660262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660262400000",
"number": "1477281749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "187 HADLEY AVE",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070113371",
"telephone_number": "973-932-4422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1053 BLOOMFIELD AVE STE 14",
"city": "CLIFTON",
"state": "NJ",
"postal_code": "070122120",
"telephone_number": "973-932-4422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DARALDIK",
"first_name": "AWS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-08-12",
"last_updated": "2022-08-12",
"certification_date": "2022-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22DI02913100",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clifton, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.