Adriana Mendietta-Saeboe DDS PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI018938 Issued in NJ

Legal business name

ADRIANA MENDIETTA-SAEBOE DDS PA

Practice address

283 Summit Ave.
Hackensack, NJ 07601-1431

Phone

(201) 343-1010

Fax

(201) 343-1038

NPI assigned

Apr 24, 2008

Last updated

Aug 27, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Adriana M. Saeboe, D.D.S.

Title

President

Phone

(201) 343-1010

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1219795200000",
    "number": "1497920185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "283 SUMMIT AVE",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011431",
            "telephone_number": "201-615-7539",
            "fax_number": "201-336-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 SUMMIT AVE.",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011431",
            "telephone_number": "201-343-1010",
            "fax_number": "201-343-1038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADRIANA MENDIETTA-SAEBOE DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-08-27",
        "status": "A",
        "authorized_official_last_name": "SAEBOE",
        "authorized_official_first_name": "ADRIANA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-343-1010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI018938",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "8942",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "0005239265",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; 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.