Individual provider Active NPI

Wenjie Yu, DMD

  • General Practice Dentistry
  • West Hartford, CT
National Provider Identifier
1518221407
Registry record updated Sep 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
010767 Issued in CT
Practice address
12 N Main St Ste 101
101
West Hartford, CT 06107-1932
Phone
(860) 236-4249
Fax
(860) 236-4249
NPI assigned
Jun 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2013

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 010767 CT Primary

Addresses

Primary practice location

12 N Main St Ste 101
101
West Hartford, CT 06107-1932

Mailing address

12 N Main St Ste 101
101
West Hartford, CT 06107-1932
Phone (860) 236-4249

Other identifiers 1

IdentifierTypeStateIssuer
004011136MedicaidCT

Other names 1

  • Dr. Wenjie Yu Professional name

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

LicenseStateTypeSpecialty
010767CTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1340668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379030400000",
    "number": "1518221407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 N MAIN ST STE 101",
            "address_2": "101",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071932",
            "telephone_number": "860-236-4249",
            "fax_number": "860-236-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 N MAIN ST STE 101",
            "address_2": "101",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061071932",
            "telephone_number": "860-236-4249",
            "fax_number": "860-236-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YU",
        "first_name": "WENJIE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-26",
        "last_updated": "2013-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004011136",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENJIE",
            "last_name": "YU",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in West Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; 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.