Active NPI
Samar Hubbi, D.M.D.
- Endodontics
- Newark, NJ
National Provider Identifier
1962684142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 22DI02360500
- Practice address
- 110 Bergen Street
Reception Area #4
Newark, NJ 07101-0328 - Phone
- (973) 972-4690
- NPI assigned
- Nov 29, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 22DI02360500 | NJ | Primary |
Addresses
Primary practice location
110 Bergen Street
Reception Area #4
Newark, NJ 07101-0328
Mailing address
PO Box 1709
110 Bergen Street
Newark, NJ 07101
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170109002499 | CA | Order and Referring Only - Other (Physician) | 9032490941 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02360500 | NJ | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1196294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1196294400000",
"number": "1962684142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1709",
"address_2": "110 BERGEN STREET",
"city": "NEWARK",
"state": "NJ",
"postal_code": "07101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 BERGEN STREET",
"address_2": "RECEPTION AREA #4",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071010328",
"telephone_number": "973-972-4690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUBBI",
"first_name": "SAMAR",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-29",
"last_updated": "2007-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "NJ",
"license": "22DI02360500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newark, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.