NPIMap

Organization Active NPI

Yale-New Haven Hospital

  • Oral and Maxillofacial Surgery (Dentist)
  • New Haven, CT
National Provider Identifier
1528453883
Registry record updated Apr 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
0044 Issued in CT
Legal business name
YALE-NEW HAVEN HOSPITAL
Practice address
1450 Chapel St
Oral & Maxillofacial Surgery
New Haven, CT 06511-4405
Phone
(203) 688-1288
Fax
(203) 688-4461
NPI assigned
Apr 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2015

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

Authorized official

Name
Mr. Richard D'Aquilla
Title
President
Phone
(203) 688-2606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 0044 CT Primary

Addresses

Primary practice location

1450 Chapel St
Oral & Maxillofacial Surgery
New Haven, CT 06511-4405

Mailing address

20 York Street - Dental
New Haven, CT 06510-3220
Phone (203) 688-1288

Other identifiers 1

IdentifierTypeStateIssuer
004011318MedicaidCT

National Provider Directory

National Provider Directory
Tax ID family
Yale New Haven Emerg23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1428019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428019200000",
    "number": "1528453883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK STREET - DENTAL",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103220",
            "telephone_number": "203-688-1288",
            "fax_number": "203-688-4461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 CHAPEL ST",
            "address_2": "ORAL & MAXILLOFACIAL SURGERY",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065114405",
            "telephone_number": "203-688-1288",
            "fax_number": "203-688-4461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YALE-NEW HAVEN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-03",
        "last_updated": "2015-04-03",
        "status": "A",
        "authorized_official_last_name": "D'AQUILLA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-688-2606",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "0044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004011318",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2015; 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.