Individual provider Active NPI

Irene Kathuria, D.D.S.

  • General Practice Dentistry
  • Perth Amboy, NJ
National Provider Identifier
1912200171
Registry record updated Oct 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22DI02457800 Issued in NJ
Practice address
275 Hobart St
Perth Amboy, NJ 08861-3396
Phone
(732) 376-9333
NPI assigned
Dec 9, 2010
Last updated
Oct 30, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2018

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 22DI02457800 NJ Primary

Addresses

Primary practice location

275 Hobart St
Perth Amboy, NJ 08861-3396

Mailing address

5 Lee CT
Lebanon, NJ 08833-2113
Phone (908) 752-2656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241104003788 NJ Practitioner - Dentist 1456605641 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02457800NJMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
City of Newark CurrentSince Oct 1, 2024 Accepting new patients
City of Newark CurrentSince Oct 1, 2024 Accepting new patients
City of Newark Past Accepting new patients

Locations

110 William St
Newark, NJ 07102
Phone (973) 424-4271

394 University Ave
Newark, NJ 07102
Phone (800) 734-7083

Interoperability endpoints

  • Direct secure messaging: irene.kathuria.p1@direct.memhc.nextgenshare.com

Organizations & group practices 3

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": "1291852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1912200171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 LEE CT",
            "city": "LEBANON",
            "state": "NJ",
            "postal_code": "088332113",
            "telephone_number": "908-752-2656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 HOBART ST",
            "city": "PERTH AMBOY",
            "state": "NJ",
            "postal_code": "088613396",
            "telephone_number": "732-376-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATHURIA",
        "first_name": "IRENE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-09",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "22DI02457800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perth Amboy, NJ

Sources for this page

Verify at the official NPI Registry.