NPIMap

Individual provider Active NPI

Hadi A Lutfi, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Hackensack, NJ
National Provider Identifier
1649622762
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
4698 Issued in WV
Practice address
20 Prospect Ave Ste 719
Hackensack, NJ 07601-1974
Phone
(551) 996-5002
Fax
(551) 996-5099
NPI assigned
Jul 13, 2016
Last updated
Jun 22, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 4698 WV Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 22DI02957500 NJ
Student in an Organized Health Care Education/Training Program 390200000X 2901022013 MI
Student in an Organized Health Care Education/Training Program 390200000X LA

Addresses

Primary practice location

20 Prospect Ave Ste 719
Hackensack, NJ 07601-1974

Mailing address

20 Prospect Ave Ste 719
Hackensack, NJ 07601-1974
Phone (551) 996-5002

Other practice location 1

102 James St Ste 201
Edison, NJ 08820-3970
Phone (551) 996-5002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240212001019 NJ Practitioner - Oral Medicine 6406143866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Medicine
Education
New York University College of Dentistry, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

20 Prospect Ave
Suite 719
Hackensack, NJ 07601-1974
Phone (551) 996-5002

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02957500NJMDOral and Maxillofacial Surgery (Dentist)
4698WVMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Hackensack Meridian Health Medical Group - Complex Care PC Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1649622762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE STE 719",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011974",
            "telephone_number": "551-996-5002",
            "fax_number": "551-996-5099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PROSPECT AVE STE 719",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076011974",
            "telephone_number": "551-996-5002",
            "fax_number": "551-996-5099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 James St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Edison",
            "state": "NJ",
            "postal_code": "088203970",
            "country_code": "US",
            "telephone_number": "551-996-5002",
            "fax_number": "551-996-5099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LUTFI",
        "first_name": "HADI",
        "middle_name": "A",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-07-13",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WV",
            "license": "4698",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI02957500",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "2901022013",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "LA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hackensack, NJ

Sources for this page

Verify at the official NPI Registry.