NPIMap

Individual provider Active NPI

Theresa Huh, DMD

  • General Practice Dentistry
  • East Hartford, CT
National Provider Identifier
1487767711
Registry record updated Nov 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
009843 Issued in CT
Practice address
800 Silver LN
Suite 222
East Hartford, CT 06118-1296
Phone
(860) 263-7791
Fax
(860) 216-0316
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 009843 CT
General Practice Dentistry 1223G0001X 009843 CT Primary

Addresses

Primary practice location

800 Silver LN
Suite 222
East Hartford, CT 06118-1296

Mailing address

800 Silver LN
Suite 222
East Hartford, CT 06118-1296
Phone (860) 263-7791

Other identifiers 3

IdentifierTypeStateIssuer
1487767711MedicaidCT
TH60092MedicaidRI
8119-3OtherRIBLUE CROSS BLUE SHIELD

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
9843CTMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
White Dental, LLC General Practice Past Accepting new patients
Tooth Time Dentistry, LLC 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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415577600000",
    "number": "1487767711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SILVER LN",
            "address_2": "SUITE 222",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061181296",
            "telephone_number": "860-263-7791",
            "fax_number": "860-216-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SILVER LN",
            "address_2": "SUITE 222",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061181296",
            "telephone_number": "860-263-7791",
            "fax_number": "860-216-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUH",
        "first_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2014-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "009843",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "009843",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487767711",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TH60092",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8119-3",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; 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.