Dr Tejal Pathak LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI20276 Issued in NJ

Legal business name

DR TEJAL PATHAK LLC

Practice address

400 S Main St
Suite 2R
Wharton, NJ 07885-2043

Phone

(973) 328-1417

NPI assigned

May 16, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tejal Pathak, DDS

Title

President

Phone

(973) 328-1417

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1619184264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S MAIN ST",
            "address_2": "SUITE 2R",
            "city": "WHARTON",
            "state": "NJ",
            "postal_code": "078852043",
            "telephone_number": "973-328-1417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S MAIN ST",
            "address_2": "SUITE 2R",
            "city": "WHARTON",
            "state": "NJ",
            "postal_code": "078852043",
            "telephone_number": "973-328-1417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR TEJAL PATHAK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PATHAK",
        "authorized_official_first_name": "TEJAL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "973-328-1417",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI20276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "DI20276",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.