Individual provider Active NPI

Reshma Rajan, DDS

  • General Practice Dentistry
  • Norwalk, CT
National Provider Identifier
1780050948
Registry record updated Aug 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
011475 Issued in CT
Practice address
360 Connecticut Ave
Norwalk, CT 06854-1824
Phone
(203) 831-0080
NPI assigned
Aug 11, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2015

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 011475 CT Primary

Addresses

Primary practice location

360 Connecticut Ave
Norwalk, CT 06854-1824

Mailing address

17 Dartmouth Ave Apt 4B
Bridgewater, NJ 08807-3425
Phone (908) 635-1669

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160229000334 CT Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1951606052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011475CTMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: rrajan577633@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439510400000",
    "number": "1780050948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 DARTMOUTH AVE APT 4B",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088073425",
            "telephone_number": "908-635-1669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 CONNECTICUT AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068541824",
            "telephone_number": "203-831-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAJAN",
        "first_name": "RESHMA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2015-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "011475",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.