DR. KEERTHI SHETTY VITTAL (NPI# 1295180933) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295180933 |
| Entity Type | Individual |
| Full Name | DR. KEERTHI SHETTY VITTAL |
| Credential | DDS |
| Practice Address |
359 S Washington Ave Bergenfield NJ 07621-4311 |
| Mailing Address |
675 Handwerg Dr River Vale NJ 07675-6410 |
| Practice Telephone | 2013852500 |
| Mailing Telephone | 2017839889 |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
22D102615500 | NJ | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1100 Centennial Ave, Piscataway, NJ 088544152 | 7325628555 |
| Street Address |
359 S WASHINGTON AVE |
| City | BERGENFIELD |
| State | NJ |
| Zip Code | 07621-4311 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134272719 | James Park | Dentist | 359 S Washington Ave, Bergenfield, NJ 07621-4311 | 2007-01-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669952115 | Sublime Therapy | Massage Therapist | 80 N Washington Ave, Unite L4, Bergenfield, NJ 07621 | 2018-08-15 |
| 1619487824 | Perseverance A Okai Adjetey | Registered Nurse | 23 Lake Street, Bergenfield, NJ 07621 | 2017-10-03 |
| 1285144469 | Stacie Lynn Morvay | Nurse Practitioner | 129 Liberty Rd Apt B, Bergenfield, NJ 07621 | 2017-10-02 |
| 1295254308 | Keren Nussbaum | Speech-Language Pathologist | 60 Glenwood Drive S, Bergenfield, NJ 07621 | 2017-09-11 |
| 1538608450 | Lcn Medical Group | Internal Medicine | 136 N. Washington Ave. Suite 201, Bergenfield, NJ 07621 | 2017-02-13 |
| 1154782969 | Martine Meleance | Counselor | 386 West Main St, Berganfield, NJ 07621 | 2016-03-08 |
| 1609257591 | Maria C. Stone, Lcsw, LLC | Social Worker | 29 Legion Drive, Bergenfield, NJ 07621 | 2015-06-16 |
| 1003219536 | Ismile Dental Associates | Dentist | 22 N Washington Ave., Bergenfield, NJ 07621 | 2014-09-29 |
| 1710399415 | Maria Rena Penecilla | Registered Nurse | 74 Madison Ave, Bergenfield, NJ 07621 | 2014-05-29 |
| 1619394954 | Russell L Sadang | Physical Therapist | 103 Carnation St, Bergenfield, NJ 07621 | 2014-03-25 |
| Find all providers in zip 07621 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245649680 | James Y Kang | Dentist | 485 S Washington Ave, Bergenfield, NJ 07621-4313 | 2014-08-11 |
| 1033378575 | Bergen Dental Practice, P.C. | Dentist | 21 Magnolia St, Bergenfield, NJ 07621-3812 | 2008-06-09 |
| 1245411081 | Arnold William Fisher | Dentist | 109 S Washington Ave, Bergenfield, NJ 07621-2343 | 2007-11-20 |
| 1912101734 | Kohan Kevin Yee | Dentist | 35 N Washington Ave, Bergenfield, NJ 07621-2918 | 2007-06-14 |
| 1013125269 | Young Tae Do | Dentist | 99 New Bridge Rd, Bergenfield, NJ 07621-4114 | 2007-05-20 |
| 1487869145 | Darren Tong | Dentist | 19 Legion Dr, Bergenfield, NJ 07621-2314 | 2007-05-14 |
| 1265553838 | Ehab Tanios Shahid | Dentist | 29 W Church St, Bergenfield, NJ 07621-1703 | 2007-04-02 |
| 1366569295 | Nicolas Bochi | Dentist | 22 N Washington Ave, Bergenfield, NJ 07621-2126 | 2007-03-24 |
| 1548384654 | Murray Joseph Leben | Dentist | 147 S Washington Ave, Bergenfield, NJ 07621-2988 | 2007-03-16 |
| 1134272719 | James Park | Dentist | 359 S Washington Ave, Bergenfield, NJ 07621-4311 | 2007-01-18 |
| Find all providers in BERGENFIELD | ||||
| City | BERGENFIELD |
| Zip Code | 07621 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.