Individual provider Active NPI

Susanna Kayserman, DDS

  • Dentist
  • Warren, NJ
National Provider Identifier
1992815260
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
021856 Issued in NJ
Practice address
10 Mountain Blvd
Suite a East
Warren, NJ 07059
Phone
(908) 753-0003
Fax
(908) 753-0076
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 021856 NJ Primary

Addresses

Primary practice location

10 Mountain Blvd
Suite a East
Warren, NJ 07059

Mailing address

10 Mountain Blvd
Suite a East
Warren, NJ 07059
Phone (908) 753-0003

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
021856NJMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992815260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MOUNTAIN BLVD",
            "address_2": "SUITE A EAST",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "07059",
            "telephone_number": "908-753-0003",
            "fax_number": "908-753-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 MOUNTAIN BLVD",
            "address_2": "SUITE A EAST",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "07059",
            "telephone_number": "908-753-0003",
            "fax_number": "908-753-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYSERMAN",
        "first_name": "SUSANNA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "021856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.