Individual provider Active NPI

Sumit Yadav, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Farmington, CT
National Provider Identifier
1013260942
Registry record updated Dec 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
010367 Issued in CT
Practice address
263 Farmington Ave
L 7063
Farmington, CT 06030-1000
Phone
(860) 679-2664
Fax
(860) 679-1920
NPI assigned
Oct 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 010367 CT Primary

Addresses

Primary practice location

263 Farmington Ave
L 7063
Farmington, CT 06030-1000

Mailing address

263 Farmington Ave
Mc3905
Farmington, CT 06030-3905
Phone (860) 679-2207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150203000326 CT Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1759606304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010367CTMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1350345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418947200000",
    "number": "1013260942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "address_2": "MC3905",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060303905",
            "telephone_number": "860-679-2207",
            "fax_number": "860-679-1899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE",
            "address_2": "L 7063",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060301000",
            "telephone_number": "860-679-2664",
            "fax_number": "860-679-1920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YADAV",
        "first_name": "SUMIT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-16",
        "last_updated": "2014-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CT",
            "license": "010367",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.