Active NPI
Jayakrishnan Varma
- Dentist
- Worcester, MA
National Provider Identifier
1740044189
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN10000512
- Practice address
- 68 Stafford St
Worcester, MA 01603-1450 - Phone
- (617) 358-8300
- NPI assigned
- Feb 7, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | DN10000512 | MA | Primary |
Addresses
Primary practice location
68 Stafford St
Worcester, MA 01603-1450
Mailing address
18 Constitution CT
Hopkinton, MA 01748-2891
Phone (857) 423-4618
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN10000512 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726012800000",
"number": "1740044189",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18 CONSTITUTION CT",
"city": "HOPKINTON",
"state": "MA",
"postal_code": "017482891",
"telephone_number": "857-423-4618"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "68 STAFFORD ST",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016031450",
"telephone_number": "617-358-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VARMA",
"first_name": "JAYAKRISHNAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-02-07",
"last_updated": "2024-09-11",
"certification_date": "2024-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN10000512",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.