Medina Diana Dadurian, D.M.D

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DI017957 Issued in NJ

Practice address

2 Sears Drive
Suite 102
Paramus, NJ 07652

Phone

(201) 791-4113

Fax

(201) 791-2512

NPI assigned

Sep 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Dadurian Dental Care P.C.

  • Pediatric Dentistry
  • Paramus, NJ
  • NPI 1710129994
  NPD (past) Authorized official

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333929600000",
    "number": "1548351588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 SEARS DRIVE",
            "address_2": "SUTIE 102",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "07652",
            "telephone_number": "201-791-4113",
            "fax_number": "201-265-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 SEARS DRIVE",
            "address_2": "SUITE 102",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "07652",
            "telephone_number": "201-791-4113",
            "fax_number": "201-791-2512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DADURIAN",
        "first_name": "MEDINA",
        "middle_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2012-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "DI017957",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "4081",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL",
            "identifier": "7989",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kyle Christopher D'Amico, DPT, COMT
• Lisa Rae D'Huyvetter, FNP
• Debra Renae Dacosta, LCSW
• Phillicia Dacosta, LAC
• Dadurian Dental Care P.C.
• Veronica Dalcero, LCSW
• Ji-Nee Dalton, PT, DPT
• Kimia Damaghi
• Damor Mental Health Center LLC
• Daniel Samadi, M.D. PC

• Pediatric Dentistry in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.