Individual provider Active NPI

Theodore A. Oshetsky, D.M.D.

  • General Practice Dentistry
  • West Long Branch, NJ
National Provider Identifier
1871653113
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI01409700 Issued in NJ
Practice address
60 State Route 36
Ste B2
West Long Branch, NJ 07764-1428
Phone
(732) 229-5004
Fax
(732) 229-0599
NPI assigned
Dec 9, 2006
Sex
Male
Sole proprietor
Yes

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 22DI01409700 NJ Primary

Addresses

Primary practice location

60 State Route 36
Ste B2
West Long Branch, NJ 07764-1428

Mailing address

6 Maple PL
Oceanport, NJ 07757-1625
Phone (732) 263-1282

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
22DI01409700NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1165622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871653113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 MAPLE PL",
            "city": "OCEANPORT",
            "state": "NJ",
            "postal_code": "077571625",
            "telephone_number": "732-263-1282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 STATE ROUTE 36",
            "address_2": "STE B2",
            "city": "WEST LONG BRANCH",
            "state": "NJ",
            "postal_code": "077641428",
            "telephone_number": "732-229-5004",
            "fax_number": "732-229-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSHETSKY",
        "first_name": "THEODORE",
        "middle_name": "A.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI01409700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Long Branch, 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.