Shivani C Suvarna, BDS, MSD

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

13280 Issued in CT

Practice address

263 Farmington Ave Dept of Reconstructive Sciences
L7045
Farmington, CT 06030-0001

Phone

(860) 679-2649

NPI assigned

Sep 28, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1275204380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82 BRITTANY FARMS RD # J237",
            "city": "NEW BRITAIN",
            "state": "CT",
            "postal_code": "060531267",
            "telephone_number": "206-612-5764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVE DEPT OF RECONSTRUCTIVE SCIENCES",
            "address_2": "L7045",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060300001",
            "telephone_number": "860-679-2649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUVARNA",
        "first_name": "SHIVANI",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "BDS, MSD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61086406",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "WA",
            "license": "DE61086406",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CT",
            "license": "13280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Suponitsky, MD
• Supreme Limousine LLC
• Sunitha Rani Sura, M.D.
• Grace Susanin, LMSW
• Michael Sussal, LCSW
• Rosemary A. Swanke, APRN
• Talia Swanke, DO
• Anna Sweeney, PA-C
• Anna Madeline Sweeney
• Krystal Swift, MSN, APRN, FNP-BC

• Prosthodontics in Farmington, CT
• Providers in Farmington, CT by specialty
• Prosthodontics in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.