Individual provider Active NPI

Aman Syed, DDS

  • General Practice Dentistry
  • New London, CT
National Provider Identifier
1114950607
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8727 Issued in CT
Practice address
21 Montauk Ave
Suite 102
New London, CT 06320-4906
Phone
(860) 447-9280
Fax
(860) 437-1938
NPI assigned
Jul 8, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8727 CT Primary

Addresses

Primary practice location

21 Montauk Ave
Suite 102
New London, CT 06320-4906

Mailing address

457 Stanley Dr
Glastonbury, CT 06033-2623
Phone (860) 430-9520

Other identifiers 1

IdentifierTypeStateIssuer
002087270MedicaidCT

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
8727CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Reidville Dentistry & Implants Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114950607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "457 STANLEY DR",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060332623",
            "telephone_number": "860-430-9520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 MONTAUK AVE",
            "address_2": "SUITE 102",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204906",
            "telephone_number": "860-447-9280",
            "fax_number": "860-437-1938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SYED",
        "first_name": "AMAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "8727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002087270",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New London, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.