Healthcare Provider Details

I. General information

NPI: 1649839762
Provider Name (Legal Business Name): IRENE SHUMAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2019
Last Update Date: 08/03/2025
Certification Date: 08/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

260 OLD HOOK RD STE 202
WESTWOOD NJ
07675-3123
US

IV. Provider business mailing address

260 OLD HOOK RD STE 202
WESTWOOD NJ
07675-3123
US

V. Phone/Fax

Practice location:
  • Phone: 201-664-5656
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberD13134500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: