Individual provider Active NPI

Nadezda Sanders, DDS

  • Dentist
  • Old Bridge, NJ
National Provider Identifier
1730449182
Registry record updated Aug 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02537900 Issued in NJ
Practice address
2515 Hwy. 516
Old Bridge, NJ 08857
Phone
(732) 679-3600
NPI assigned
May 19, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02537900 NJ Primary

Addresses

Primary practice location

2515 Hwy. 516
Old Bridge, NJ 08857

Mailing address

122 Bennett Ave
Staten Island, NY 10312-4021
Phone (347) 571-3734

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
I20150615001296 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 5294046496

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Gerald J Whiteman DDS PA Dentist Past Accepting new patients
NJ Team Dental Center PA Dentist Past Accepting new patients

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": "1337385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438646400000",
    "number": "1730449182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 BENNETT AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103124021",
            "telephone_number": "347-571-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 HWY. 516",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "08857",
            "telephone_number": "732-679-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "NADEZDA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-19",
        "last_updated": "2015-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02537900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

Verify at the official NPI Registry.