Active NPI
Roshanak Elmendorf, DDS
- Dentist
- Bloomingdale, NJ
National Provider Identifier
1871669408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D18731
- Practice address
- 142 Main Street
Bloomingdale, NJ 07403 - Phone
- (973) 283-2900
- Fax
- (973) 283-1154
- NPI assigned
- Nov 27, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | D18731 | NJ | Primary |
Addresses
Primary practice location
142 Main Street
Bloomingdale, NJ 07403
Mailing address
PO Box 300
142 Main St
Bloomingdale, NJ 07403
Phone (973) 283-2900
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
| License | State | Type | Specialty |
|---|---|---|---|
| D18731 | NJ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871669408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 300",
"address_2": "142 MAIN ST",
"city": "BLOOMINGDALE",
"state": "NJ",
"postal_code": "07403",
"telephone_number": "973-283-2900",
"fax_number": "973-283-1154"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "142 MAIN STREET",
"city": "BLOOMINGDALE",
"state": "NJ",
"postal_code": "07403",
"telephone_number": "973-283-2900",
"fax_number": "973-283-1154"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELMENDORF",
"first_name": "ROSHANAK",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "D18731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomingdale, 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.