Individual provider Active NPI

Easwar Natarajan, D.D.S.

  • Oral and Maxillofacial Pathology Dentistry
  • Farmington, CT
National Provider Identifier
1548473523
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Pathology DentistryTaxonomy code 1223P0106X
License
009509 Issued in CT
Practice address
263 Farmington Avenue
University Dentists
Farmington, CT 06030
Phone
(860) 679-3170
Fax
(860) 679-8162
NPI assigned
May 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 009509 CT Primary
General Practice Dentistry 1223G0001X 009509 CT

Addresses

Primary practice location

263 Farmington Avenue
University Dentists
Farmington, CT 06030

Mailing address

263 Farmington Avenue
University Dentists
Farmington, CT 06030-2820
Phone (860) 679-3170

Other identifiers 1

IdentifierTypeStateIssuer
1548473523MedicaidCT

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address enatarajan10417@direct.med.uchc.edu

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090120000412 CT Practitioner - Pathology 1557424496 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-3692

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
009509CTMDOral and Maxillofacial Pathology Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
University Dentists CurrentSince Jul 12, 2017 Accepting new patients
University of Connecticut Health Center CurrentSince Oct 1, 2008 Accepting new patients
University of Connecticut Health Center CurrentSince Jul 12, 2017 Accepting new patients
University of Connecticut Health Center Oral and Maxillofacial Pathology CurrentSince Oct 1, 2008 Accepting new patients

Locations

263 Farmington Ave
Farmington, CT 06030
Phone (860) 679-4477

Interoperability endpoints

  • Direct secure messaging: enatarajan10417@direct.med.uchc.edu

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1548473523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVENUE",
            "address_2": "UNIVERSITY DENTISTS",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060302820",
            "telephone_number": "860-679-3170",
            "fax_number": "860-679-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 FARMINGTON AVENUE",
            "address_2": "UNIVERSITY DENTISTS",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "06030",
            "telephone_number": "860-679-3170",
            "fax_number": "860-679-8162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATARAJAN",
        "first_name": "EASWAR",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-07",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "CT",
            "license": "009509",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "009509",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1548473523",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "enatarajan10417@direct.med.uchc.edu",
            "affiliation": "N",
            "address_1": "263 Farmington Avenue",
            "address_2": "University Dentists",
            "city": "Farmington",
            "state": "CT",
            "country_code": "US",
            "postal_code": "06030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Farmington, CT

Sources for this page

Verify at the official NPI Registry.