Tushar Udeshi, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

04801 Issued in NH

Practice address

367 Route 120 Unit C
Lebanon, NH 03766-1430

Phone

(603) 643-4142

Fax

(603) 643-1740

NPI assigned

Feb 8, 2007

Last updated

Jan 26, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Angela J Santavicca DDS PLLC

  • General Practice Dentistry
  • Lebanon, NH
  • NPI 1639385289
  NPD (past)

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1184764946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "367 ROUTE 120 UNIT C",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661430",
            "telephone_number": "516-728-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367 ROUTE 120 UNIT C",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037661430",
            "telephone_number": "603-643-4142",
            "fax_number": "603-643-1740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UDESHI",
        "first_name": "TUSHAR",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "051814",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NH",
            "license": "04801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02671823",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gretchen Elizabeth Twork, M.D.
• Tracy Susan Tylee, M.D.
• Barbara Ann Tyler
• Michelle Diane Tyler, M.D.
• Harmony Lynn Tyner, MD
• Joy Udoh, DO
• Ikram Ullah, M.D,
• Micah Cary Ulrich, MD
• Jessica Underdahl, B.S.
• Meredith Underhill, RN

• Dentist in Lebanon, NH
• Providers in Lebanon, NH by specialty
• Dentist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.