Individual provider Active NPI

Noah - Chivian, DDS

  • Endodontics
  • West Orange, NJ
National Provider Identifier
1689701864
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
6901 Issued in NJ
Practice address
100 Northfield Ave
West Orange, NJ 07052-4702
Phone
(973) 731-4800
Fax
(973) 731-1153
NPI assigned
Feb 27, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 6901 NJ Primary

Addresses

Primary practice location

100 Northfield Ave
West Orange, NJ 07052-4702

Mailing address

100 Northfield Ave
West Orange, NJ 07052-4702
Phone (973) 731-4800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150624002702 NJ Order and Referring Only - DentistPractitioner - Dentist 6002127578

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6901NJMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689701864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 NORTHFIELD AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524702",
            "telephone_number": "973-731-4800",
            "fax_number": "973-731-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NORTHFIELD AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524702",
            "telephone_number": "973-731-4800",
            "fax_number": "973-731-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIVIAN",
        "first_name": "NOAH",
        "middle_name": "-",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NJ",
            "license": "6901",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Orange, NJ

Sources for this page

Verify at the official NPI Registry.