Individual provider Active NPI

Gargi Bhagavatula, D.D.S.

  • General Practice Dentistry
  • New Haven, CT
National Provider Identifier
1093193484
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
13593 Issued in CT
Practice address
123 York St Ste 4L
New Haven, CT 06511-5665
Phone
(203) 781-8051
NPI assigned
May 18, 2015
Last updated
May 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1001031 WI
General Practice Dentistry 1223G0001X 13593 CT Primary

Addresses

Primary practice location

123 York St Ste 4L
New Haven, CT 06511-5665

Mailing address

630 Chapel St Apt 546
New Haven, CT 06510-3163
Phone (402) 213-6077

Other practice location 1

6048 W Mequon Rd
Mequon, WI 53092-1938
Phone (402) 213-6077

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

LicenseStateTypeSpecialty
1001031WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
New Haven Dental Group General Practice PastSince Jun 3, 2025 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1431907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1093193484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 CHAPEL ST APT 546",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103163",
            "telephone_number": "402-213-6077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 YORK ST STE 4L",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115665",
            "telephone_number": "203-781-8051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6048 W Mequon Rd",
            "address_purpose": "LOCATION",
            "city": "Mequon",
            "state": "WI",
            "postal_code": "530921938",
            "country_code": "US",
            "telephone_number": "402-213-6077",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BHAGAVATULA",
        "first_name": "GARGI",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-05-18",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001031",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "13593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.