Individual provider Active NPI

Zachary Zysman

  • Dentist
  • Clifton, NJ
National Provider Identifier
1780387837
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI03008900 Issued in NJ
Practice address
991 Van Houten Ave
Clifton, NJ 07013-2643
Phone
(973) 777-1933
NPI assigned
Mar 27, 2023
Last updated
Aug 27, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI03008900 NJ Primary

Addresses

Primary practice location

991 Van Houten Ave
Clifton, NJ 07013-2643

Mailing address

333 River St Apt 1130
Hoboken, NJ 07030-5872
Phone (201) 527-5171

Other practice location 1

1455 Broad St # 105A
Bloomfield, NJ 07003-3047
Phone (862) 727-7116

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
22DI03008900NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Louis R Vita DDS LLC PastSince Sep 1, 2024 Accepting new patients

Organizations & group practices 1

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": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1780387837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 RIVER ST APT 1130",
            "city": "HOBOKEN",
            "state": "NJ",
            "postal_code": "070305872",
            "telephone_number": "201-527-5171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "991 VAN HOUTEN AVE",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070132643",
            "telephone_number": "973-777-1933"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1455 Broad St # 105A",
            "address_purpose": "LOCATION",
            "city": "Bloomfield",
            "state": "NJ",
            "postal_code": "070033047",
            "country_code": "US",
            "telephone_number": "862-727-7116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZYSMAN",
        "first_name": "ZACHARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-27",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI03008900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clifton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.