Individual provider Active NPI

Amit V Desai, DMD

  • General Practice Dentistry
  • Cheshire, CT
National Provider Identifier
1174636260
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
CT008852 Issued in CT
Practice address
1122 Highland Avenue
Cheshire, CT 06410
Phone
(203) 272-7271
Fax
(203) 272-8882
NPI assigned
Aug 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

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 CT008852 CT Primary

Addresses

Primary practice location

1122 Highland Avenue
Cheshire, CT 06410

Mailing address

1122 Highland Avenue
Cheshire, CT 06410
Phone (203) 272-7271

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
I20150129000108 CT Order and Referring Only - Oral SurgeryPractitioner - Oral SurgeryPractitioner - Dentist 9638493398

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CT008852CTMDGeneral Practice Dentistry
8852CTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Dentistry, Inc General Practice PastSince Sep 12, 2013 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": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174636260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 HIGHLAND AVENUE",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "06410",
            "telephone_number": "203-272-7271",
            "fax_number": "203-272-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 HIGHLAND AVENUE",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "06410",
            "telephone_number": "203-272-7271",
            "fax_number": "203-272-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESAI",
        "first_name": "AMIT",
        "middle_name": "V",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "CT008852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheshire, CT

Sources for this page

Verify at the official NPI Registry.