Anam Tariq

Primary specialty

DentistTaxonomy code 122300000X

License

22DI02723200 Issued in NJ

Practice address

1145 E Chestnut Ave
Vineland, NJ 08360

Phone

(856) 899-5442

NPI assigned

May 25, 2018

Last updated

Sep 8, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1527206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536364800000",
    "number": "1841781754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 E CHESTNUT AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083605001",
            "telephone_number": "610-203-7871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 E CHESTNUT AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "08360",
            "telephone_number": "856-899-5442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2919 N 22nd St",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191321505",
            "country_code": "US",
            "telephone_number": "610-203-7871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TARIQ",
        "first_name": "ANAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-05-25",
        "last_updated": "2018-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS041690",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02723200",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Vineland, NJ
• Providers in Vineland, NJ by specialty
• Dentist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2018; 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.