Active NPI
Irina Tyurina, DMD
- General Practice Dentistry
- Enfield, CT
National Provider Identifier
1619064565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 8331
- Practice address
- 115 Elm St
Suite 204
Enfield, CT 06082-3712 - Phone
- (860) 741-6644
- Fax
- (860) 741-6650
- NPI assigned
- Oct 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8331 | CT | Primary |
Addresses
Primary practice location
115 Elm St
Suite 204
Enfield, CT 06082-3712
Mailing address
115 Elm St
Suite 204
Enfield, CT 06082-3712
Phone (860) 741-6644
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: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160205002203 | CT | Order and Referring Only - Oral Surgery | 7810291192 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619064565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 ELM ST",
"address_2": "SUITE 204",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060823712",
"telephone_number": "860-741-6644",
"fax_number": "860-741-6650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 ELM ST",
"address_2": "SUITE 204",
"city": "ENFIELD",
"state": "CT",
"postal_code": "060823712",
"telephone_number": "860-741-6644",
"fax_number": "860-741-6650"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TYURINA",
"first_name": "IRINA",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-10-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CT",
"license": "8331",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Enfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.