Individual provider Active NPI

Sathish Iyer, D.D.S

  • Pediatric Dentistry
  • Old Bridge, NJ
National Provider Identifier
1740491471
Registry record updated Apr 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
22DI023249 Issued in NJ
Practice address
3333 Highway 9 N FL 2
Old Bridge, NJ 08857-2691
Phone
(732) 737-7336
Fax
(732) 862-3498
NPI assigned
May 24, 2007
Last updated
Apr 24, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 22DI023249 NJ Primary

Addresses

Primary practice location

3333 Highway 9 N FL 2
Old Bridge, NJ 08857-2691

Mailing address

3333 Highway 9 N FL 2
Old Bridge, NJ 08857-2691
Phone (732) 737-7336

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
22DI023249NJMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Old Bridge Pediatric Dentistry LLC Pediatric Dentistry PastSince Jan 28, 2024 Accepting new patients
The Little Teeth Workshop 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335225600000",
    "number": "1740491471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 HIGHWAY 9 N FL 2",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572691",
            "telephone_number": "732-737-7336",
            "fax_number": "732-862-3498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 HIGHWAY 9 N FL 2",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088572691",
            "telephone_number": "732-737-7336",
            "fax_number": "732-862-3498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IYER",
        "first_name": "SATHISH",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-24",
        "last_updated": "2012-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI023249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Old Bridge, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; 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.