Individual provider Active NPI

Ameet S Patheja, DMD

  • Dentist
  • Passaic, NJ
National Provider Identifier
1679096077
Registry record updated Oct 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DS041465 Issued in PA
Practice address
625 Main Ave Ste 315
Passaic, NJ 07055-4952
Phone
(973) 574-1000
NPI assigned
Jul 18, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DS041465 PA Primary

Addresses

Primary practice location

625 Main Ave Ste 315
Passaic, NJ 07055-4952

Mailing address

3362 Moore LN
Huntingdon Valley, PA 19006-1745
Phone (215) 756-7223

Other practice location 1

4409 New Falls Rd
Levittown, PA 19056-3005
Phone (215) 756-7223

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

LicenseStateTypeSpecialty
DS041465PAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Levittown Smiles LLC Dentist CurrentSince Oct 20, 2024 Accepting new patients
Smile Central Passaic P.C. Multi-Specialty Past Accepting new patients

Locations

4409 New Falls Rd
Levittown, PA 19056
Phone (215) 756-7223

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": "1500336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1679096077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3362 MOORE LN",
            "city": "HUNTINGDON VALLEY",
            "state": "PA",
            "postal_code": "190061745",
            "telephone_number": "215-756-7223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 MAIN AVE STE 315",
            "city": "PASSAIC",
            "state": "NJ",
            "postal_code": "070554952",
            "telephone_number": "973-574-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4409 New Falls Rd",
            "address_purpose": "LOCATION",
            "city": "Levittown",
            "state": "PA",
            "postal_code": "190563005",
            "country_code": "US",
            "telephone_number": "215-756-7223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATHEJA",
        "first_name": "AMEET",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-18",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS041465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Passaic, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.