NPIMap

Organization Active NPI

Deepa Jayam, DMD PC

  • Dentist
  • Corona, NY
National Provider Identifier
1699071449
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
053694 Issued in NY
Legal business name
DEEPA JAYAM, DMD PC
Practice address
3709 Junction Blvd
Corona, NY 11368-1740
Phone
(516) 884-1654
NPI assigned
Jan 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2011

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

Authorized official

Name
Dr. Deepa Jayam, DMDNPI 1063677953
Title
President
Phone
(516) 884-1654

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 053694 NY Primary

Addresses

Primary practice location

3709 Junction Blvd
Corona, NY 11368-1740

Mailing address

3 Parkway Dr
Roslyn Heights, NY 11577-2705
Phone (516) 656-0881

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1296000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296000000000",
    "number": "1699071449",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 PARKWAY DR",
            "city": "ROSLYN HEIGHTS",
            "state": "NY",
            "postal_code": "115772705",
            "telephone_number": "516-656-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3709 JUNCTION BLVD",
            "city": "CORONA",
            "state": "NY",
            "postal_code": "113681740",
            "telephone_number": "516-884-1654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEEPA JAYAM, DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-26",
        "last_updated": "2011-01-26",
        "status": "A",
        "authorized_official_last_name": "JAYAM",
        "authorized_official_first_name": "DEEPA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-884-1654",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "053694",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; 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.