Edmund Tamas Takata

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

90 S Main St Ste 201
Middletown, CT 06457-3649

Phone

(860) 358-6418

NPI assigned

Apr 2, 2026

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1775088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1518808906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 S MAIN ST STE 201",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 S MAIN ST STE 201",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064573649",
            "telephone_number": "860-358-6418"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13 High St",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "CT",
            "postal_code": "064801616",
            "country_code": "US",
            "telephone_number": "860-358-6418",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "42 E High St Ste 205",
            "address_purpose": "LOCATION",
            "city": "East Hampton",
            "state": "CT",
            "postal_code": "064241056",
            "country_code": "US",
            "telephone_number": "860-358-6418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAKATA",
        "first_name": "EDMUND",
        "middle_name": "TAMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-04-02",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sweet Tooth Pediatric Dentistry
• Karina Szczepanczyk, M.D.
• Elizabeth Anna Ta, DO
• Brian Taber
• Jeffrey H Takahashi, MD
• Christine Joanne Taliercio, D.O.
• Allissa Tamiso, LPC, NCC
• Michael Tammaro, PA-C
• Michael Tao, M.D.
• Lisa Tarchini, OT

• Student in an Organized Health Care Education/Training Program in Middletown, CT
• Providers in Middletown, CT by specialty
• Student in an Organized Health Care Education/Training Program in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.