NPIMap

Organization Active NPI

Yale-New Haven Hospital

  • Pediatric Dentistry
  • New Haven, CT
National Provider Identifier
1790170033
Registry record updated Apr 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
044 Issued in CT
Legal business name
YALE-NEW HAVEN HOSPITAL
Practice address
1 Long Wharf Dr
Suite 403
New Haven, CT 06511-5991
Phone
(203) 688-3000
Fax
(203) 688-3050
NPI assigned
Apr 3, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2016

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

Authorized official

Name
Mr. Richard D'Aquilla
Title
President
Phone
(203) 688-2606

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dental AnesthesiologyGroup: 193200000X MULTI-SPECIALTY GROUP 1223D0004X 044 CT
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 044 CT Primary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X 044 CT
Dental HygienistGroup: 193200000X MULTI-SPECIALTY GROUP 124Q00000X 044 CT

Addresses

Primary practice location

1 Long Wharf Dr
Suite 403
New Haven, CT 06511-5991

Mailing address

20 York Street - Dental
New Haven, CT 06510-3202
Phone (203) 688-1288

Other identifiers 1

IdentifierTypeStateIssuer
008058656MedicaidCT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
07D1098498Yale New Haven Hospital/ Maternal Fetal Medicine1 Long Wharf Dr, 2ND FLR, New Haven, CT 06511Provider-performed microscopyApr 20, 2027
07D2105513Yale New Haven Hospital Dental Services1 Long Wharf Dr, New Haven, CT 06511Certificate of waiverNov 24, 2027

National Provider Directory

National Provider Directory
Tax ID family
Yale New Haven Emerg23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Practitioners & affiliated clinicians

Practitioners 5

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": "1428019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460937600000",
    "number": "1790170033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 YORK STREET - DENTAL",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065103202",
            "telephone_number": "203-688-1288",
            "fax_number": "203-688-4461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 LONG WHARF DR",
            "address_2": "SUITE 403",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065115991",
            "telephone_number": "203-688-3000",
            "fax_number": "203-688-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YALE-NEW HAVEN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-03",
        "last_updated": "2016-04-18",
        "status": "A",
        "authorized_official_last_name": "D'AQUILLA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-688-2606",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223D0004X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Dental Anesthesiology",
            "state": "CT",
            "license": "044",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "044",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CT",
            "license": "044",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": "CT",
            "license": "044",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008058656",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.