Active NPI
Cheddi Bradlaugh Jagan, D.D.S.
- Dentist
- South Richmond Hill, NY
National Provider Identifier
1437510559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 033968
- Practice address
- 11512 Liberty Ave
2B
South Richmond Hill, NY 11419-1902 - Phone
- (917) 657-3901
- NPI assigned
- Mar 16, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 033968 | NY | Primary |
Addresses
Primary practice location
11512 Liberty Ave
2B
South Richmond Hill, NY 11419-1902
Mailing address
11512 Liberty Ave
2B
South Richmond Hill, NY 11419-1902
Phone (917) 657-3901
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 033968 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458086400000",
"number": "1437510559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11512 LIBERTY AVE",
"address_2": "2B",
"city": "SOUTH RICHMOND HILL",
"state": "NY",
"postal_code": "114191902",
"telephone_number": "917-657-3901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11512 LIBERTY AVE",
"address_2": "2B",
"city": "SOUTH RICHMOND HILL",
"state": "NY",
"postal_code": "114191902",
"telephone_number": "917-657-3901"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAGAN",
"first_name": "CHEDDI",
"middle_name": "BRADLAUGH",
"name_prefix": "Mr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-03-16",
"last_updated": "2016-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NY",
"license": "033968",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Richmond Hill, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.