Individual provider Active NPI

Yusuf Sheikh, DMD

  • Periodontics
  • Brattleboro, VT
National Provider Identifier
1780178822
Registry record updated Sep 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
016.0134160 Issued in VT
Practice address
1046 Western Ave Ste 1
Brattleboro, VT 05301-2513
Phone
(802) 230-0110
NPI assigned
Jun 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 2.013571 CT
Periodontics 1223P0300X 016.0134160 VT Primary

Addresses

Primary practice location

1046 Western Ave Ste 1
Brattleboro, VT 05301-2513

Mailing address

2 Trail Run Apt 3202
Vernon, CT 06066-3973
Phone (817) 217-5884

Other practice location 1

75 Berlin Rd Ste 108
Cromwell, CT 06416-2633
Phone (860) 756-5258

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20191127002211 MA Order and Referring Only - DentistPractitioner - Dentist 8426481771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2.013571CTMDPeriodontist
016.0134160VTMDPeriodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Periodontics Incorporated Dentist PastSince Jul 1, 2021 Accepting new patients

Organizations & group practices 1

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": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695513600000",
    "number": "1780178822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 TRAIL RUN APT 3202",
            "city": "VERNON",
            "state": "CT",
            "postal_code": "060663973",
            "telephone_number": "817-217-5884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1046 WESTERN AVE STE 1",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053012513",
            "telephone_number": "802-230-0110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Berlin Rd Ste 108",
            "address_purpose": "LOCATION",
            "city": "Cromwell",
            "state": "CT",
            "postal_code": "064162633",
            "country_code": "US",
            "telephone_number": "860-756-5258",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEIKH",
        "first_name": "YUSUF",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-21",
        "last_updated": "2023-09-24",
        "certification_date": "2023-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CT",
            "license": "2.013571",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "VT",
            "license": "016.0134160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brattleboro, VT

Sources for this page

Verify at the official NPI Registry.