Individual provider Active NPI

Aliza Bracha Kreitman, DMD

  • General Practice Dentistry
  • Highland Park, NJ
National Provider Identifier
1508494246
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DIO2826000 Issued in NJ
Practice address
34 S 4TH Ave
Highland Park, NJ 08904-2621
Phone
(732) 572-3226
NPI assigned
Mar 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NJ
General Practice Dentistry 1223G0001X 22DIO2826000 NJ Primary

Addresses

Primary practice location

34 S 4TH Ave
Highland Park, NJ 08904-2621

Mailing address

13-55 Zito CT
Fair Lawn, NJ 07410-5115
Phone (551) 265-5882

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
22DIO2826000NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1508494246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13-55 ZITO CT",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074105115",
            "telephone_number": "551-265-5882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 S 4TH AVE",
            "city": "HIGHLAND PARK",
            "state": "NJ",
            "postal_code": "089042621",
            "telephone_number": "732-572-3226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREITMAN",
        "first_name": "ALIZA",
        "middle_name": "BRACHA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-30",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NJ",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DIO2826000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Highland Park, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; 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.