Individual provider Active NPI

Joseph Ross Yudin, DDS

  • General Practice Dentistry
  • Brattleboro, VT
National Provider Identifier
1679512461
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
999 Issued in VT
Practice address
72 Landmark Hill Dr
Brattleboro, VT 05301-9168
Phone
(802) 254-9244
Fax
(802) 254-3820
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 999 VT Primary

Addresses

Primary practice location

72 Landmark Hill Dr
Brattleboro, VT 05301-9168

Mailing address

72 Landmark Hill Dr
Brattleboro, VT 05301-9168
Phone (802) 254-9244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190125000274 NH Order and Referring Only - DentistPractitioner - Dentist 5890032056

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Dental Associates General Practice Past Accepting new patients
True Point Dental, PLLC Past Accepting new patients

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294099200000",
    "number": "1679512461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 LANDMARK HILL DR",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053019168",
            "telephone_number": "802-254-9244",
            "fax_number": "802-254-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 LANDMARK HILL DR",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053019168",
            "telephone_number": "802-254-9244",
            "fax_number": "802-254-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YUDIN",
        "first_name": "JOSEPH",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2011-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VT",
            "license": "999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brattleboro, VT

Sources for this page

Verify at the official NPI Registry.