Active NPI
Sriniketh Srinivasa, DMD
- Dentist
- Jersey City, NJ
National Provider Identifier
1659705192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DI02549700
- Practice address
- 22 Glenwood Ave
Jersey City, NJ 07306-4631 - Phone
- (201) 333-0883
- Fax
- (201) 333-3225
- NPI assigned
- Aug 31, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DI02549700 | NJ | Primary |
Addresses
Primary practice location
22 Glenwood Ave
Jersey City, NJ 07306-4631
Mailing address
144 E Midland Ave
Paramus, NJ 07652-4116
Phone (201) 634-1476
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI02549700 | NJ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jersey City Dentistry Professional Corporation | Dentist | Current | Accepting new patients |
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 and National Provider Directory roles.
-
- Dentist
- Jersey City, NJ
- NPI 1700720620
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1489622400000",
"number": "1659705192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "144 E MIDLAND AVE",
"city": "PARAMUS",
"state": "NJ",
"postal_code": "076524116",
"telephone_number": "201-634-1476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 GLENWOOD AVE",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073064631",
"telephone_number": "201-333-0883",
"fax_number": "201-333-3225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SRINIVASA",
"first_name": "SRINIKETH",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-08-31",
"last_updated": "2017-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "DI02549700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jersey City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.