Elm Street Dental

Primary specialty

DentistTaxonomy code 122300000X

License

010825 Issued in CT

Legal business name

ELM STREET DENTAL

Practice address

1100 Barnum Ave
Stratford, CT 06614-4901

Phone

(716) 239-5889

NPI assigned

Oct 18, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Dharam Tayal, D.D.S.

Title

Dentist

Phone

(716) 239-5889

Specialties & licenses 1

Addresses

Other names 1

• Dental Smiles Doing business as

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448323200000",
    "number": "1659624393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 BARNUM AVE",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066144901",
            "telephone_number": "716-239-5889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 BARNUM AVE",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066144901",
            "telephone_number": "716-239-5889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELM STREET DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-18",
        "last_updated": "2015-11-24",
        "status": "A",
        "authorized_official_last_name": "TAYAL",
        "authorized_official_first_name": "DHARAM",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "716-239-5889",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CT",
            "license": "010825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dental Smiles",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Stratford, CT
• Providers in Stratford, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.