Lavanya Rajendran, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

13249 Issued in CT

Practice address

190 Hempstead St
New London, CT 06320-6248

Phone

(860) 443-2428

NPI assigned

Mar 9, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1520553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1831692425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 COPPER BEECH DR",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064102950",
            "telephone_number": "203-379-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "190 HEMPSTEAD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206248",
            "telephone_number": "860-443-2428"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "62 Wells St",
            "address_purpose": "LOCATION",
            "city": "Westerly",
            "state": "RI",
            "postal_code": "028912924",
            "country_code": "US",
            "telephone_number": "401-596-0000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "25 Copper Beech Dr",
            "address_purpose": "LOCATION",
            "city": "Cheshire",
            "state": "CT",
            "postal_code": "064102950",
            "country_code": "US",
            "telephone_number": "203-379-7006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAJENDRAN",
        "first_name": "LAVANYA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-09",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "RI",
            "license": "DEN03625",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": "12212",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CT",
            "license": "13249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linette Quinones
• Christine Wilbur Race
• Laurence I. Radin, MD
• Derek Rafeldt, MS, ATC, LAT
• Mandeep Singh Rahi, M.D.
• Aquasha Rambharose
• Alyssia B Rathbun
• Laura Denise Rau, MD
• Dereck Realejo
• Claire Reardon, MD

• Periodontics in New London, CT
• Providers in New London, CT by specialty
• Periodontics in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.