Individual provider Active NPI

Raya Aleksieva, DMD

  • General Practice Dentistry
  • Waterbury, CT
National Provider Identifier
1487053419
Registry record updated Sep 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
011403 Issued in CT
Practice address
1147 W Main St
Waterbury, CT 06708-2737
Phone
(203) 755-7541
Fax
(203) 755-1675
NPI assigned
Aug 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2016

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 011403 CT Primary

Addresses

Primary practice location

1147 W Main St
Waterbury, CT 06708-2737

Mailing address

1147 W Main St
Waterbury, CT 06708-2737
Phone (203) 755-7541

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190801002567 CT Order and Referring Only - Other (Non-Physician) 1153657895

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011403CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
West Main Family Dentistry General Practice Past Accepting new patients
West Main Dental Associates General Practice Past Accepting new patients

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": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474243200000",
    "number": "1487053419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1147 W MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082737",
            "telephone_number": "203-755-7541",
            "fax_number": "203-755-1675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1147 W MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067082737",
            "telephone_number": "203-755-7541",
            "fax_number": "203-755-1675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALEKSIEVA",
        "first_name": "RAYA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-14",
        "last_updated": "2016-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "011403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterbury, CT

Sources for this page

Verify at the official NPI Registry.