Active NPI
Harvey Scott Nisselson, DDS
- Periodontics
- Denville, NJ
National Provider Identifier
1578754719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 9688
- Practice address
- 16 Pocono Road
Suite 213
Denville, NJ 07834-2922 - Phone
- (973) 219-1700
- Fax
- (973) 625-5716
- NPI assigned
- Aug 5, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 9688 | NJ | Primary |
| Periodontics | 1223P0300X | 030542 | NY |
Addresses
Primary practice location
16 Pocono Road
Suite 213
Denville, NJ 07834-2922
Mailing address
17 Alpine Dr
Denville, NJ 07834-1416
Phone (973) 219-1700
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160415000266 | NJ | Order and Referring Only - Dentist | 0840598454 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9688 | NJ | MD | Periodontist |
| 030542 | NY | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1186272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1366156800000",
"number": "1578754719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 ALPINE DR",
"city": "DENVILLE",
"state": "NJ",
"postal_code": "078341416",
"telephone_number": "973-219-1700",
"fax_number": "973-625-5716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 POCONO ROAD",
"address_2": "SUITE 213",
"city": "DENVILLE",
"state": "NJ",
"postal_code": "078342922",
"telephone_number": "973-219-1700",
"fax_number": "973-625-5716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NISSELSON",
"first_name": "HARVEY",
"middle_name": "SCOTT",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-08-05",
"last_updated": "2013-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NJ",
"license": "9688",
"primary": true
},
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NY",
"license": "030542",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denville, NJ
- Michael Nicolai, MD
- Lauren Nicolich
- Alexandra Sara Nikolovski, PHARMD
- Nina F. Rifkind, LCSW, LLC
- Rosemaria Cyriac Nirappel
- North Jersey Center for Urologic Care PA
- North Jersey Ear Nose Throat & Hearing Ctr
- North Jersey Endocrine Consultants LLC
- North Jersey Hand Surgery PA (North Jersey Hand Therapy)
- Northwest Radiology Associates PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2013; 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.