Individual provider Active NPI

Poonam Gat, DDS

  • Dentist
  • Union City, NJ
National Provider Identifier
1497002687
Registry record updated Nov 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10825 Issued in CT
Practice address
3700 Kennedy Blvd
Union City, NJ 07087-2993
Phone
(201) 866-3737
Fax
(201) 866-6266
NPI assigned
Aug 7, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 057868-1 NY
General Practice Dentistry 1223G0001X 22DI02516600 NJ
Dentist 122300000X 10825 CT Primary

Addresses

Primary practice location

3700 Kennedy Blvd
Union City, NJ 07087-2993

Mailing address

31 River CT Apt 3003
Jersey City, NJ 07310-2036
Phone (646) 915-4003

Other practice location 1

1100 Barnum Ave
Stratford, CT 06614-4901
Phone (203) 378-2760

Other identifiers 2

IdentifierTypeStateIssuer
0439568MedicaidNJ
008042072MedicaidCT

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
22DI02516600NJMDGeneral Practice Dentistry
057868-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Dental Care General Practice CurrentSince Nov 29, 2020 Accepting new patients
Children's Dental Center, PA PastSince Nov 29, 2020 Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1344297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605916800000",
    "number": "1497002687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 RIVER CT APT 3003",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073102036",
            "telephone_number": "646-915-4003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 KENNEDY BLVD",
            "city": "UNION CITY",
            "state": "NJ",
            "postal_code": "070872993",
            "telephone_number": "201-866-3737",
            "fax_number": "201-866-6266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1100 Barnum Ave",
            "address_purpose": "LOCATION",
            "city": "Stratford",
            "state": "CT",
            "postal_code": "066144901",
            "country_code": "US",
            "telephone_number": "203-378-2760",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAT",
        "first_name": "POONAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-07",
        "last_updated": "2020-11-21",
        "certification_date": "2020-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "057868-1",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02516600",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "10825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0439568",
            "state": "NJ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008042072",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2020; 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.