Individual provider Active NPI

Matt Safari, D.D.S.

  • Pediatric Dentistry
  • Little Silver, NJ
National Provider Identifier
1811044589
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DI21210 Issued in NJ
Practice address
200 White Rd Ste 113
Little Silver, NJ 07739-1160
Phone
(732) 842-1155
Fax
(732) 842-0943
NPI assigned
Jan 4, 2007
Sex
Male
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
Pediatric Dentistry 1223P0221X DI21210 NJ Primary

Addresses

Primary practice location

200 White Rd Ste 113
Little Silver, NJ 07739-1160

Mailing address

200 White Rd Ste 113
Little Silver, NJ 07739-1160
Phone (732) 842-1155

Other identifiers 1

IdentifierTypeStateIssuer
8618208MedicaidNJ

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
DI21210NJMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811044589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WHITE RD STE 113",
            "city": "LITTLE SILVER",
            "state": "NJ",
            "postal_code": "077391160",
            "telephone_number": "732-842-1155",
            "fax_number": "732-842-0943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 WHITE RD STE 113",
            "city": "LITTLE SILVER",
            "state": "NJ",
            "postal_code": "077391160",
            "telephone_number": "732-842-1155",
            "fax_number": "732-842-0943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFARI",
        "first_name": "MATT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "DI21210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8618208",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Silver, 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.