Active NPI
Faten K Nakhla, DDS
- General Practice Dentistry
- Willingboro, NJ
National Provider Identifier
1801902804
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22DI02253300
- Practice address
- 77 Garland LN
Willingboro, NJ 08046-3011 - Phone
- (609) 880-0090
- Fax
- (609) 880-0091
- NPI assigned
- Aug 22, 2006
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22DI02253300 | NJ | Primary |
Addresses
Primary practice location
77 Garland LN
Willingboro, NJ 08046-3011
Mailing address
77 Garland LN
Willingboro, NJ 08046-3011
Phone (609) 880-0090
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Jun 7, 2019 through Jun 7, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433376000000",
"number": "1801902804",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 GARLAND LN",
"city": "WILLINGBORO",
"state": "NJ",
"postal_code": "080463011",
"telephone_number": "609-880-0090",
"fax_number": "609-880-0091"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 GARLAND LN",
"city": "WILLINGBORO",
"state": "NJ",
"postal_code": "080463011",
"telephone_number": "609-880-0090",
"fax_number": "609-880-0091"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NAKHLA",
"first_name": "FATEN",
"middle_name": "K",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-22",
"last_updated": "2015-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "22DI02253300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Willingboro, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.