Individual provider Active NPI

John A. Kush, D.M.D.

  • General Practice Dentistry
  • Annandale, NJ
National Provider Identifier
1639140676
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DI 17425 Issued in NJ
Practice address
1484 Route 31 N
Walnut Pond Professional BLDG.
Annandale, NJ 08801-3125
Phone
(908) 735-8188
Fax
(908) 735-6651
NPI assigned
Jan 29, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 DI 17425 NJ Primary

Addresses

Primary practice location

1484 Route 31 N
Walnut Pond Professional BLDG.
Annandale, NJ 08801-3125

Mailing address

47 La Costa Dr
Annandale, NJ 08801-1663
Phone (908) 730-7119

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
I20160202001055 NJ Order and Referring Only - DentistPractitioner - Dentist 6103120712

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DI 17425NJMDGeneral Practice Dentistry

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1138492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1639140676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 LA COSTA DR",
            "city": "ANNANDALE",
            "state": "NJ",
            "postal_code": "088011663",
            "telephone_number": "908-730-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1484 ROUTE 31 N",
            "address_2": "WALNUT POND PROFESSIONAL BLDG.",
            "city": "ANNANDALE",
            "state": "NJ",
            "postal_code": "088013125",
            "telephone_number": "908-735-8188",
            "fax_number": "908-735-6651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUSH",
        "first_name": "JOHN",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-29",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI 17425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, NJ

Sources for this page

Verify at the official NPI Registry.