Nishat Anbar Shahabuddin, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

22DI02811203 Issued in NJ

Practice address

3123 Kennedy Blvd
North Bergen, NJ 07047-2378

Phone

(201) 662-0662

NPI assigned

Sep 1, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Nishat Shahabuddin DMD PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Jamaica, NY
  • NPI 1194469197
  NPD Authorized official
• Bergenline Orthodontics, LLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • West New York, NJ
  • NPI 1588810410
  NPD (past)

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

{
    "created_epoch": "1598918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1992319537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 W 48TH ST APT 26A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100361385",
            "telephone_number": "917-757-0981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3123 KENNEDY BLVD",
            "city": "NORTH BERGEN",
            "state": "NJ",
            "postal_code": "070472378",
            "telephone_number": "201-662-0662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAHABUDDIN",
        "first_name": "NISHAT",
        "middle_name": "ANBAR",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-01",
        "last_updated": "2020-09-01",
        "certification_date": "2020-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "22DI02811203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "nshahabuddindds@gmail.com",
            "affiliation": "N",
            "address_1": "3123 Kennedy Blvd",
            "city": "North Bergen",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "070472378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Malak Shah, MD
• Manan Shah, MD
• Mansi Shah, MD
• Sandeep Shah, MD
• Syed Muhammad Salman Shah, MD
• Marina Shaji, M.D
• Ashraf Shaker, MD
• Ferheen Shamim, M.D.
• Robert Bernard Shapiro, D.M.D
• Fahad Sheckley, M.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in North Bergen, NJ
• Providers in North Bergen, NJ by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.