Judith Mamah, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI20512 Issued in NJ

Practice address

885 Main St
Hackensack, NJ 07601-4914

Phone

(201) 343-4302

NPI assigned

Dec 10, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Designing Smiles Igen Dental LLC

  • Dental Clinic/Center
  • Hackensack, NJ
  • NPI 1124617030
  NPD Authorized official

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

{
    "created_epoch": "1134172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1760467930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "885 MAIN ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076014914",
            "telephone_number": "201-343-4302",
            "fax_number": "201-343-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "885 MAIN ST",
            "city": "HACKENSACK",
            "state": "NJ",
            "postal_code": "076014914",
            "telephone_number": "201-343-4302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Elm Ave",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076013739",
            "country_code": "US",
            "telephone_number": "201-343-4302",
            "fax_number": "201-343-4304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAMAH",
        "first_name": "JUDITH",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-10",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI20512",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7839707",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Grace Malley, MD
• Rajit Bhoosa Malliah, M.D.
• Mary Fares Mallouhi, DDS
• Katherine Malmrose, M.S., CCC-SLP
• Mam Orthopaedics, PA
• Jeremy Robert Man, M.D.
• Lauren Kristen Mancuso, MSN, FNP-BC, FNP-C
• Pankaja A Mandhle, MD
• Alta Maness, NP
• Joan Ruth Esperanza Manglicmot, M.D

• General Practice Dentistry in Hackensack, NJ
• Providers in Hackensack, NJ by specialty
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2021; 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.