Individual provider Active NPI

Prathiba Srinidhi, DMD

  • General Practice Dentistry
  • Voorhees, NJ
National Provider Identifier
1710055843
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS031012-L Issued in PA
Practice address
64 Van Buren Rd Apt 4
Voorhees, NJ 08043-2324
Phone
(856) 772-1682
Fax
(610) 872-1924
NPI assigned
Nov 30, 2006
Sex
Female
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
General Practice Dentistry 1223G0001X DS031012-L PA Primary

Addresses

Primary practice location

64 Van Buren Rd Apt 4
Voorhees, NJ 08043-2324

Mailing address

64 Van Buren Rd Apt 4
Voorhees, NJ 08043-2324
Phone (856) 772-1682

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
DS031012-LPAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710055843",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 VAN BUREN RD APT 4",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080432324",
            "telephone_number": "856-772-1682",
            "fax_number": "610-872-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 VAN BUREN RD APT 4",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080432324",
            "telephone_number": "856-772-1682",
            "fax_number": "610-872-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SRINIDHI",
        "first_name": "PRATHIBA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS031012-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Voorhees, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.