Active NPI
Valeriia Ivanova
- General Practice Dentistry
- Linden, NJ
National Provider Identifier
1912890500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 22DI03091300
- Practice address
- 515 N Wood Ave Ste 102
Linden, NJ 07036-4173 - Phone
- (908) 743-8041
- NPI assigned
- Jun 2, 2025
- Sex
- Unspecified or another gender identity
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 22DI03091300 | NJ | Primary |
Addresses
Primary practice location
515 N Wood Ave Ste 102
Linden, NJ 07036-4173
Mailing address
2 W End Ave Apt 5W
Brooklyn, NY 11235-4884
Phone (518) 776-0072
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 |
|---|---|---|---|
| 22DI03091300 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1748822400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1748822400000",
"number": "1912890500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 W END AVE APT 5W",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112354884",
"telephone_number": "518-776-0072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "515 N WOOD AVE STE 102",
"city": "LINDEN",
"state": "NJ",
"postal_code": "070364173",
"telephone_number": "908-743-8041"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVANOVA",
"first_name": "VALERIIA",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2025-06-02",
"last_updated": "2025-06-02",
"certification_date": "2025-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "22DI03091300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Linden, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.