Active NPI
Min Deng, D.M.D.
- Pediatric Dentistry
- Yalesville, CT
National Provider Identifier
1073877197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 010929
- Practice address
- 60 Church St
Yalesville, CT 06492-2340 - Phone
- (203) 774-0019
- NPI assigned
- Jul 3, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 010929 | CT | Primary |
Addresses
Primary practice location
60 Church St
Yalesville, CT 06492-2340
Mailing address
60 Church St
Yalesville, CT 06492-2340
Phone (203) 774-0019
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010929 | CT | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410134400000",
"number": "1073877197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "60 CHURCH ST",
"city": "YALESVILLE",
"state": "CT",
"postal_code": "064922340",
"telephone_number": "203-774-0019",
"fax_number": "203-774-0034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "60 CHURCH ST",
"city": "YALESVILLE",
"state": "CT",
"postal_code": "064922340",
"telephone_number": "203-774-0019"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DENG",
"first_name": "MIN",
"name_prefix": "Mrs.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-03",
"last_updated": "2014-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CT",
"license": "010929",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yalesville, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.