Individual provider Active NPI

Alla Pavlushkin, DDS

  • General Practice Dentistry
  • Old Bridge, NJ
National Provider Identifier
1801900303
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DI19271 Issued in NJ
Practice address
2515 Hwy 516
Unit 2a Empire Dental PC
Old Bridge, NJ 08857
Phone
(732) 607-0909
Fax
(732) 607-7555
NPI assigned
Aug 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DI19271 NJ Primary

Addresses

Primary practice location

2515 Hwy 516
Unit 2a Empire Dental PC
Old Bridge, NJ 08857

Mailing address

2515 Hwy 516
Unit 2a
Old Bridge, NJ 08857
Phone (732) 607-0909

Other names 1

  • Dr. Thomas Rafterty Professional name

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
DI19271NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801900303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 HWY 516",
            "address_2": "UNIT 2A",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "08857",
            "telephone_number": "732-607-0909",
            "fax_number": "732-607-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 HWY 516",
            "address_2": "UNIT 2A EMPIRE DENTAL PC",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "08857",
            "telephone_number": "732-607-0909",
            "fax_number": "732-607-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAVLUSHKIN",
        "first_name": "ALLA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI19271",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "THOMAS",
            "last_name": "RAFTERTY",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Jul 8, 2007; 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.