Active NPI
Cherish Im
- Pediatric Dentistry
- Fort Lee, NJ
National Provider Identifier
1962759795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DI02510700
- Practice address
- 2029 Lemoine Ave Ste 203
Fort Lee, NJ 07024-5731 - Phone
- (201) 592-0758
- NPI assigned
- Aug 10, 2012
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DI02510700 | NJ | Primary |
Addresses
Primary practice location
2029 Lemoine Ave Ste 203
Fort Lee, NJ 07024-5731
Mailing address
513 Roff Ave Unit B
Palisades Park, NJ 07650-1807
Phone (646) 785-9488
Other practice location 1
1330 How Ln
North Brunswick, NJ 08902-1702
Phone (732) 249-1010
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 |
|---|---|---|---|
| DI02510700 | NJ | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Leaf Pediatric Dental LLC | Pediatric Dentistry | 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 and National Provider Directory roles.
-
- Pediatric Dentistry
- Fort Lee, NJ
- NPI 1649773524
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539734400000",
"number": "1962759795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "513 ROFF AVE UNIT B",
"city": "PALISADES PARK",
"state": "NJ",
"postal_code": "076501807",
"telephone_number": "646-785-9488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2029 LEMOINE AVE STE 203",
"city": "FORT LEE",
"state": "NJ",
"postal_code": "070245731",
"telephone_number": "201-592-0758"
}
],
"practiceLocations": [
{
"address_1": "1330 How Ln",
"address_purpose": "LOCATION",
"city": "North Brunswick",
"state": "NJ",
"postal_code": "089021702",
"country_code": "US",
"telephone_number": "732-249-1010",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "IM",
"first_name": "CHERISH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-08-10",
"last_updated": "2018-10-17",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NJ",
"license": "DI02510700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Lee, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.