Active NPI
Cyrus G Dehkan, DDS
- General Practice Dentistry
- Kenilworth, NJ
National Provider Identifier
1518175603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22DI01550500
- Practice address
- 409 Boulevard
Kenilworth, NJ 07033-1538 - Phone
- (908) 276-2225
- Fax
- (908) 276-1550
- NPI assigned
- May 20, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22DI01550500 | NJ | Primary |
Addresses
Primary practice location
409 Boulevard
Kenilworth, NJ 07033-1538
Mailing address
409 Boulevard
Kenilworth, NJ 07033-1538
Phone (908) 276-2225
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 |
|---|---|---|---|
| 22DI01550500 | NJ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| William J Derkasch Cyrus G Dehkan PTRS | Past | Accepting new patients | |
| Derkasch Dental Health Associates PA | General Practice | Past | 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.
-
- General Practice Dentistry
- Kenilworth, NJ
- NPI 1881874063
-
dba Derkasch & Dehkan DDS
- Dentist
- Kenilworth, NJ
- NPI 1740403435
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1518175603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 BOULEVARD",
"city": "KENILWORTH",
"state": "NJ",
"postal_code": "070331538",
"telephone_number": "908-276-2225",
"fax_number": "908-276-1550"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "409 BOULEVARD",
"city": "KENILWORTH",
"state": "NJ",
"postal_code": "070331538",
"telephone_number": "908-276-2225",
"fax_number": "908-276-1550"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEHKAN",
"first_name": "CYRUS",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "22DI01550500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenilworth, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.