Active NPI
Samar Yaseen
- Dentist
- Old Bridge, NJ
National Provider Identifier
1790479780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22DI02974900
- Practice address
- 56 Oakland Rd
Old Bridge, NJ 08857-2785 - Phone
- (832) 228-0357
- NPI assigned
- Jun 5, 2023
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 22DI02974900 | NJ | Primary |
Addresses
Primary practice location
56 Oakland Rd
Old Bridge, NJ 08857-2785
Mailing address
56 Oakland Rd
Old Bridge, NJ 08857-2785
Phone (832) 228-0357
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 |
|---|---|---|---|
| 22DI02974900 | NJ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1686787200000",
"number": "1790479780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "56 OAKLAND RD",
"city": "OLD BRIDGE",
"state": "NJ",
"postal_code": "088572785",
"telephone_number": "832-228-0357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56 OAKLAND RD",
"city": "OLD BRIDGE",
"state": "NJ",
"postal_code": "088572785",
"telephone_number": "832-228-0357"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YASEEN",
"first_name": "SAMAR",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-06-05",
"last_updated": "2023-06-15",
"certification_date": "2023-06-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22DI02974900",
"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 Jun 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.