K Jayadevan DDS

Primary specialty

DentistTaxonomy code 122300000X

License

034016 Issued in NY

Legal business name

K JAYADEVAN DDS

Practice address

5801 Sunrise Hwy
Holbrook, NY 11741-4841

Phone

(631) 567-8899

Fax

(631) 567-8118

NPI assigned

Mar 27, 2008

Organization subpart

No

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) 567-8899

Specialties & licenses 1

Addresses

Other names 1

• Dental Health Services Former legal business name

Locations

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": "1447422720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5801 SUNRISE HWY",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414841",
            "telephone_number": "631-567-8899",
            "fax_number": "631-567-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5801 SUNRISE HWY",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414841",
            "telephone_number": "631-567-8899",
            "fax_number": "631-567-8118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K JAYADEVAN DDS",
        "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": "631-567-8899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "034016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Health Services",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Dentist in Holbrook, NY
• Providers in Holbrook, NY by specialty
• Dentist in New York

• 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.