Active NPI
Jae An
- General Practice Dentistry
- Elizabeth, NJ
National Provider Identifier
1760949671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22DI02811400
- Practice address
- 65 Jefferson Ave
Elizabeth, NJ 07201-2474 - Phone
- (908) 469-9100
- NPI assigned
- Feb 27, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22DI02811400 | NJ | Primary |
Addresses
Primary practice location
65 Jefferson Ave
Elizabeth, NJ 07201-2474
Mailing address
65 Jefferson Ave
Elizabeth, NJ 07201-2474
Phone (908) 469-9100
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
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02811400 | NJ | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dream Dental Associates | Current | Accepting new patients | |
| Child Smiles Spec LLC | 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.
-
- Dental Clinic/Center
- Dumont, NJ
- NPI 1801744073
-
- Orthodontics and Dentofacial Orthopedics Dentistry
- Newark, NJ
- NPI 1184099251
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748822400000",
"number": "1760949671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "65 JEFFERSON AVE",
"city": "ELIZABETH",
"state": "NJ",
"postal_code": "072012474",
"telephone_number": "908-469-9100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "65 JEFFERSON AVE",
"city": "ELIZABETH",
"state": "NJ",
"postal_code": "072012474",
"telephone_number": "908-469-9100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AN",
"first_name": "JAE",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-02-27",
"last_updated": "2025-06-02",
"certification_date": "2025-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "22DI02811400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elizabeth, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.