Individual provider Active NPI

Adrian V. Basu, DDS

  • General Practice Dentistry
  • Shelton, CT
National Provider Identifier
1114985330
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
008548 Issued in CT
Practice address
190 Coram Ave
Shelton, CT 06484-3347
Phone
(203) 924-4115
Fax
(203) 924-1301
NPI assigned
May 4, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 008548 CT Primary

Addresses

Primary practice location

190 Coram Ave
Shelton, CT 06484-3347

Mailing address

461 Orange Center Rd
Orange, CT 06477-2952
Phone (203) 298-9401

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
I20150716000485 CT Order and Referring Only - DentistPractitioner - Dentist 6002129343

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008548CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Associates of Shelton, LLP General Practice Past Accepting new patients
Dr Joseph S Madrak OD LLC PastSince Sep 2, 2015 Accepting new patients

Organizations & group practices 2

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1114985330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 ORANGE CENTER RD",
            "city": "ORANGE",
            "state": "CT",
            "postal_code": "064772952",
            "telephone_number": "203-298-9401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 CORAM AVE",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064843347",
            "telephone_number": "203-924-4115",
            "fax_number": "203-924-1301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASU",
        "first_name": "ADRIAN",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "008548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

Verify at the official NPI Registry.