Individual provider Active NPI

Deepa Nyayapathi, DMD

  • Dentist
  • Metuchen, NJ
National Provider Identifier
1588077754
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02540300 Issued in NJ
Practice address
295 Main St
Metuchen, NJ 08840-2428
Phone
(732) 226-0568
NPI assigned
Jun 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02540300 NJ Primary

Addresses

Primary practice location

295 Main St
Metuchen, NJ 08840-2428

Mailing address

295 Main St
Metuchen, NJ 08840-2428

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150608000907 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2365763992

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02540300NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1401926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1588077754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 MAIN ST",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088402428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 MAIN ST",
            "city": "METUCHEN",
            "state": "NJ",
            "postal_code": "088402428",
            "telephone_number": "732-226-0568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYAYAPATHI",
        "first_name": "DEEPA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-05",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02540300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metuchen, NJ

Sources for this page

Verify at the official NPI Registry.