Active NPI
Debora Ohevshalom
- Dentist
- Hackensack, NJ
National Provider Identifier
1659752194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 058867-1
- Practice address
- 30 Prospect Avenue
Hackensack, NJ 07601 - Phone
- (551) 996-2000
- NPI assigned
- Jun 10, 2015
- Sex
- Female
- Sole proprietor
- No
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 | 058867-1 | NY | Primary |
Addresses
Primary practice location
30 Prospect Avenue
Hackensack, NJ 07601
Mailing address
30 Prospect Avenue
Hackensack, NJ 07601
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 |
|---|---|---|---|
| 058867-1 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433894400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1477612800000",
"number": "1659752194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 PROSPECT AVENUE",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "07601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 PROSPECT AVENUE",
"city": "HACKENSACK",
"state": "NJ",
"postal_code": "07601",
"telephone_number": "551-996-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OHEVSHALOM",
"first_name": "DEBORA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-10",
"last_updated": "2016-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "058867-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hackensack, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.