Individual provider Active NPI

Isaac Menasha, DDS

  • Dentist
  • Edison, NJ
National Provider Identifier
1932255684
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02183900 Issued in NJ
Practice address
1726 State Route 27
Edison, NJ 08817-3449
Phone
(732) 985-7666
Fax
(732) 985-6841
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02183900 NJ Primary

Addresses

Primary practice location

1726 State Route 27
Edison, NJ 08817-3449

Mailing address

1726 State Route 27
Edison, NJ 08817-3449
Phone (732) 985-7666

Other practice location 1

1025 W Saint Georges Ave
Linden, NJ 07036-6134
Phone (908) 486-8809

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
I20150617002731 NJ Order and Referring Only - DentistPractitioner - Dentist 4587975511

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1932255684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 STATE ROUTE 27",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088173449",
            "telephone_number": "732-985-7666",
            "fax_number": "732-985-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1726 STATE ROUTE 27",
            "city": "EDISON",
            "state": "NJ",
            "postal_code": "088173449",
            "telephone_number": "732-985-7666",
            "fax_number": "732-985-6841"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1025 W Saint Georges Ave",
            "address_purpose": "LOCATION",
            "city": "Linden",
            "state": "NJ",
            "postal_code": "070366134",
            "country_code": "US",
            "telephone_number": "908-486-8809",
            "fax_number": "908-486-2669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENASHA",
        "first_name": "ISAAC",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02183900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edison, NJ

Sources for this page

Verify at the official NPI Registry.