Individual provider Active NPI

Monica Jethwani, DDS

  • Endodontics
  • Depew, NY
National Provider Identifier
1871867069
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
063785 Issued in NY
Practice address
6350 Transit Rd
Depew, NY 14043-1039
Phone
(716) 206-0718
NPI assigned
Mar 6, 2012
Last updated
Aug 6, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DE60665049 WA
General Practice Dentistry 1223G0001X 0401413488 VA
Endodontics 1223E0200X 063785 NY Primary

Addresses

Primary practice location

6350 Transit Rd
Depew, NY 14043-1039

Mailing address

140 Glendon PL Unit a
Williamsville, NY 14221-6092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
063785NYMDEndodontist
DE60665049WAMDEndodontist
0401413488VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Nurani, Mitchell, Kim, PC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1330992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1871867069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 GLENDON PL UNIT A",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142216092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6350 TRANSIT RD",
            "city": "DEPEW",
            "state": "NY",
            "postal_code": "140431039",
            "telephone_number": "716-206-0718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JETHWANI",
        "first_name": "MONICA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-06",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WA",
            "license": "DE60665049",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401413488",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NY",
            "license": "063785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Depew, NY

Sources for this page

Verify at the official NPI Registry.