Individual provider Active NPI

Tripthi Shetty, DDS

  • General Practice Dentistry
  • East Brunswick, NJ
National Provider Identifier
1528076494
Registry record updated Nov 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DI21550 Issued in NJ
Practice address
577 Cranbury Rd Suite C-1
East Brunswick, NJ 08816-5403
Phone
(732) 432-0123
Fax
(732) 432-7979
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DI21550 NJ Primary

Addresses

Primary practice location

577 Cranbury Rd Suite C-1
East Brunswick, NJ 08816-5403

Mailing address

577 Cranbury Rd Suite C-1
East Brunswick, NJ 08816-5403
Phone (732) 432-0123

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
DI21550NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Dental Studio, P.C. CurrentSince Oct 1, 2022 Accepting new patients

Locations

577 Cranbury Rd
Ste C1
East Brunswick, NJ 08816
Phone (732) 432-0123

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699315200000",
    "number": "1528076494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "577 CRANBURY RD SUITE C-1",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165403",
            "telephone_number": "732-432-0123",
            "fax_number": "732-432-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "577 CRANBURY RD SUITE C-1",
            "city": "EAST BRUNSWICK",
            "state": "NJ",
            "postal_code": "088165403",
            "telephone_number": "732-432-0123",
            "fax_number": "732-432-7979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHETTY",
        "first_name": "TRIPTHI",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI21550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Brunswick, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.