Healthcare Provider Details

I. General information

NPI: 1659217057
Provider Name (Legal Business Name): NADIRAH DENT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 DAVIDSON AVE STE 210
SOMERSET NJ
08873-1312
US

IV. Provider business mailing address

100 DAVIDSON AVE STE 210
SOMERSET NJ
08873-1312
US

V. Phone/Fax

Practice location:
  • Phone: 908-429-7799
  • Fax: 866-611-9616
Mailing address:
  • Phone: 908-429-7799
  • Fax: 866-611-9616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number26NJ15585300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: