Individual provider Active NPI

Jyoti Ranjan Kansara, DDS

  • General Practice Dentistry
  • Plainfield, NJ
National Provider Identifier
1609420447
Registry record updated Jul 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02768600 Issued in NJ
Practice address
200 W 2ND St Ste 109
Plainfield, NJ 07060-1218
Phone
(908) 755-0303
NPI assigned
Jul 30, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2019

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 22DI02768600 NJ Primary

Addresses

Primary practice location

200 W 2ND St Ste 109
Plainfield, NJ 07060-1218

Mailing address

1306 Plaza Dr
Woodbridge, NJ 07095
Phone (732) 397-6977

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
I20191014000023 NJ Order and Referring Only - DentistPractitioner - Dentist 3375874969

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02768600NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1564444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564444800000",
    "number": "1609420447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 PLAZA DR",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "07095",
            "telephone_number": "732-397-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W 2ND ST STE 109",
            "city": "PLAINFIELD",
            "state": "NJ",
            "postal_code": "070601218",
            "telephone_number": "908-755-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANSARA",
        "first_name": "JYOTI",
        "middle_name": "RANJAN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-07-30",
        "last_updated": "2019-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02768600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainfield, NJ

Sources for this page

Verify at the official NPI Registry.