Provider Demographics
NPI:1609864826
Name:SHALMAN, JANE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:
Last Name:SHALMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 E 1ST AVE
Mailing Address - Street 2:STE.5
Mailing Address - City:ROSELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07203-1669
Mailing Address - Country:US
Mailing Address - Phone:908-259-0505
Mailing Address - Fax:908-259-9885
Practice Address - Street 1:711 E 1ST AVE
Practice Address - Street 2:STE.5
Practice Address - City:ROSELLE
Practice Address - State:NJ
Practice Address - Zip Code:07203-1669
Practice Address - Country:US
Practice Address - Phone:908-259-0505
Practice Address - Fax:908-259-9885
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI020018001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7353103Medicaid