Divine Smiles PC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

DIVINE SMILES PC

Practice address

1574 Chapel St
New Haven, CT 06511-4205

Phone

(917) 428-4543

NPI assigned

Mar 29, 2023

Last updated

Nov 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Shande Adinyaguev, DDSNPI 1346862570

Title

Owner

Phone

(917) 428-4543

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shande Adinyaguev, DDS

  • General Practice Dentistry
  • New Haven, CT
  • NPI 1346862570
  Authorized official Same address or phone

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

{
    "created_epoch": "1680048000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699315200000",
    "number": "1184328551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1574 CHAPEL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114205",
            "telephone_number": "203-865-1480",
            "fax_number": "203-865-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1574 CHAPEL ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114205",
            "telephone_number": "917-428-4543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIVINE SMILES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-29",
        "last_updated": "2023-11-07",
        "certification_date": "2023-11-07",
        "status": "A",
        "authorized_official_last_name": "ADINYAGUEV",
        "authorized_official_first_name": "SHANDE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-428-4543",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Daniel Disesa, MD
• Marcello Michael Distasio Jr., M.D., PH.D.
• Michael Distasio
• Stephen Ditter, RPH
• Divine Love Homecare LLC
• Ebony Dix, M.D.
• Irene Dixe de Oliveira Santo, MD
• Samira Dixon, PHARMD
• Dixwell Newhallville Community Mental Health Services, NC.
• Dixwell-Newhallville Community Mental Health Services Inc

• Dental Clinic/Center in New Haven, CT
• Providers in New Haven, CT by specialty
• Dental Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2023; 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.