Individual provider Active NPI

Alan Ferretti, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • South Plainfield, NJ
National Provider Identifier
1790842326
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
22DI02071300 Issued in NJ
Practice address
4917 Stelton Rd
South Plainfield, NJ 07080-1113
Phone
(917) 757-7491
NPI assigned
Jan 2, 2007
Last updated
Dec 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 043635 NY
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 22DI02071300 NJ Primary

Addresses

Primary practice location

4917 Stelton Rd
South Plainfield, NJ 07080-1113

Mailing address

4917 Stelton Rd
South Plainfield, NJ 07080-1113
Phone (917) 757-7491

Other identifiers 1

IdentifierTypeStateIssuer
02313564MedicaidNY

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
22DI02071300NJMDOral and Maxillofacial Surgery (Dentist)
043635NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
JDS Dental Care PLLC Oral and Maxillofacial Surgery PastSince Oct 20, 2019 Accepting new patients
Jack Miceli DDS PC 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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1790842326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4917 STELTON RD",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070801113",
            "telephone_number": "917-757-7491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4917 STELTON RD",
            "city": "SOUTH PLAINFIELD",
            "state": "NJ",
            "postal_code": "070801113",
            "telephone_number": "917-757-7491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRETTI",
        "first_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "043635",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI02071300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02313564",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Plainfield, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.

Verify at the official NPI Registry.