Individual provider Active NPI

Kamel Shehada, DMD

  • Dentist
  • Carteret, NJ
National Provider Identifier
1841858230
Registry record updated Nov 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02899900 Issued in NJ
Practice address
125 Washington Ave FL 3
Carteret, NJ 07008-2635
Phone
(732) 733-6690
NPI assigned
May 31, 2019
Last updated
Nov 11, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02899900 NJ Primary
Dentist 122300000X 019.032117 IL

Addresses

Primary practice location

125 Washington Ave FL 3
Carteret, NJ 07008-2635

Mailing address

1 Dunn Rd Unit G
Hillsborough, NJ 08844-3527
Phone (708) 717-1781

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
019.032117ILMDDentist
22DI02899900NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699660800000",
    "number": "1841858230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 DUNN RD UNIT G",
            "city": "HILLSBOROUGH",
            "state": "NJ",
            "postal_code": "088443527",
            "telephone_number": "708-717-1781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 WASHINGTON AVE FL 3",
            "city": "CARTERET",
            "state": "NJ",
            "postal_code": "070082635",
            "telephone_number": "732-733-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEHADA",
        "first_name": "KAMEL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-31",
        "last_updated": "2023-11-11",
        "certification_date": "2023-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02899900",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.032117",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carteret, NJ

Sources for this page

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