NPIMap

Organization Active NPI

K. Jayadevan DDS PC

Doing business as Moriches Dental Associates

  • Dentist
  • Center Moriches, NY
National Provider Identifier
1194997460
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
Legal business name
K. JAYADEVAN DDS PC
Doing business as
Moriches Dental Associates
Practice address
760 Montauk Hwy
Suite 6
Center Moriches, NY 11934-2230
Phone
(631) 874-4707
Fax
(631) 874-4720
NPI assigned
Mar 27, 2008
Last updated
Mar 27, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Authorized official

Name
Dr. Krishnaswamy Jayadevan, DDS
Title
Owner
Phone
(631) 874-4707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X NU Primary

Addresses

Primary practice location

760 Montauk Hwy
Suite 6
Center Moriches, NY 11934-2230

Mailing address

760 Montauk Hwy
Suite 6
Center Moriches, NY 11934-2230
Phone (631) 874-4707

Other names 1

  • Moriches Dental Associates Doing business as

National Provider Directory

National Provider Directory
Tax ID family
K Jayadevan DDS PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

760 Montauk Hwy
Ste 6
Center Moriches, NY 11934
Phone (631) 874-4707

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1206576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1194997460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 MONTAUK HWY",
            "address_2": "SUITE 6",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "119342230",
            "telephone_number": "631-874-4707",
            "fax_number": "631-874-4720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 MONTAUK HWY",
            "address_2": "SUITE 6",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "119342230",
            "telephone_number": "631-874-4707",
            "fax_number": "631-874-4720"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K. JAYADEVAN DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-27",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "JAYADEVAN",
        "authorized_official_first_name": "KRISHNASWAMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-874-4707",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moriches Dental Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Center Moriches, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.