Individual provider Active NPI

Jayasanker Viayan Valiyaparambil, DMD

  • General Practice Dentistry
  • Woodbridge, CT
National Provider Identifier
1285075754
Registry record updated Mar 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
011000 Issued in CT
Practice address
8 Pumpkin Patch Rd
Woodbridge, CT 06525-2523
Phone
(860) 331-3743
NPI assigned
Jul 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2014

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 011000 CT Primary

Addresses

Primary practice location

8 Pumpkin Patch Rd
Woodbridge, CT 06525-2523

Mailing address

8 Pumpkin Patch Rd
Woodbridge, CT 06525
Phone (860) 331-3743

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20210721004218 AZ Practitioner - Oral Surgery 4284964347 Practice locations: Glendale, AZ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011000CTMDGeneral Practice Dentistry
10319AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Empire Dental Esthetics of Arizona CurrentSince Feb 24, 2022 Accepting new patients
Pankaj R Goyal DDS Az PC PastSince Jul 25, 2021 Accepting new patients

Locations

7170 W Camino San Xavier
Ste A101
Glendale, AZ 85308
Phone (623) 594-2057

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395360000000",
    "number": "1285075754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 PUMPKIN PATCH RD",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "06525",
            "telephone_number": "860-331-3743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 PUMPKIN PATCH RD",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "065252523",
            "telephone_number": "860-331-3743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALIYAPARAMBIL",
        "first_name": "JAYASANKER",
        "middle_name": "VIAYAN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-12",
        "last_updated": "2014-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "011000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, CT

Sources for this page

Verify at the official NPI Registry.