Active NPI
Mega Manchanda
- Pediatric Dentistry
- Lodi, NJ
National Provider Identifier
1689145690
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 22DI02974600
- Practice address
- 170 Main St
Units 109-110
Lodi, NJ 07644 - Phone
- (201) 397-1420
- NPI assigned
- Dec 17, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatric Dentistry | 1223P0221X | 22DI02974600 | NJ | Primary |
Addresses
Primary practice location
170 Main St
Units 109-110
Lodi, NJ 07644
Mailing address
345 E 24TH St
New York, NY 10010-4020
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 |
|---|---|---|---|
| 22DI02974600 | NJ | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1545004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694390400000",
"number": "1689145690",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 E 24TH ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100104020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 MAIN ST",
"address_2": "UNITS 109-110",
"city": "LODI",
"state": "NJ",
"postal_code": "07644",
"telephone_number": "201-397-1420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANCHANDA",
"first_name": "MEGA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-17",
"last_updated": "2023-09-11",
"certification_date": "2023-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NJ",
"license": "22DI02974600",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lodi, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.