Individual provider Active NPI

Rajan Jain, DMD

  • Dentist
  • Bronx, NY
National Provider Identifier
1639738222
Registry record updated Nov 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
062870 Issued in NY
Practice address
327 E Fordham Rd FRNT 2
Bronx, NY 10458-5002
Phone
(702) 449-6502
NPI assigned
Jun 7, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02757200 NJ
Dentist 122300000X DS042228 PA
Dentist 122300000X 062870 NY Primary

Addresses

Primary practice location

327 E Fordham Rd FRNT 2
Bronx, NY 10458-5002

Mailing address

208 Lenox Ave Ste 147
Westfield, NJ 07090-5120

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
I20190809000784 NJ Order and Referring Only - DentistPractitioner - Dentist 4587991815

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
062870NYMDDentist
DS042228PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Skyline Dental Arts PC Dentist Current Accepting new patients
Ridge Dentistry PC CurrentSince Mar 5, 2023 Accepting new patients

Locations

327 E Fordham Rd
Frnt 2
Bronx, NY 10458
Phone (702) 449-6502

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1639738222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 LENOX AVE STE 147",
            "city": "WESTFIELD",
            "state": "NJ",
            "postal_code": "070905120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 E FORDHAM RD FRNT 2",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104585002",
            "telephone_number": "702-449-6502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAIN",
        "first_name": "RAJAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-07",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02757200",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS042228",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "062870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.