Individual provider Active NPI

Isabella Yiroa Chen, DMD

  • General Practice Dentistry
  • New Haven, CT
National Provider Identifier
1851852339
Registry record updated Aug 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
12847 Issued in CT
Practice address
428 Columbus Avenue
Dental
New Haven, CT 06519
Phone
(203) 503-3040
Fax
(203) 503-3187
NPI assigned
Mar 27, 2019
Last updated
Aug 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12847 CT Primary
Student in an Organized Health Care Education/Training Program 390200000X 12497 CT

Addresses

Primary practice location

428 Columbus Avenue
Dental
New Haven, CT 06519

Mailing address

400 Columbus Avenue
Credentialing Specialist
New Haven, CT 06519-1233
Phone (203) 503-3000

Other practice location 1

263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-2000

Other identifiers 1

IdentifierTypeStateIssuer
004235893MedicaidCT

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
I20200915001404 CT Practitioner - Dentist 7911232582 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cornell Scott Hill Health Corporation CurrentSince Aug 3, 2020 Accepting new patients

Locations

121 Wakelee Ave
Ansonia, CT 06401
Phone (203) 503-3570

122 Wilmot Rd
New Haven, CT 06515
Phone (203) 503-3741

226 Dixwell Ave
New Haven, CT 06511
Phone (203) 503-3470

400 Columbus Ave
New Haven, CT 06519
Phone (203) 503-3174

428 Columbus Ave
New Haven, CT 06519
Phone (203) 503-3228

Interoperability endpoints

  • Direct secure messaging: ichen477754@direct.ynhh.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1851852339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 COLUMBUS AVENUE",
            "address_2": "CREDENTIALING SPECIALIST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191233",
            "telephone_number": "203-503-3000",
            "fax_number": "203-503-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "428 COLUMBUS AVENUE",
            "address_2": "DENTAL",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06519",
            "telephone_number": "203-503-3040",
            "fax_number": "203-503-3187"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "263 Farmington Ave",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "CT",
            "postal_code": "060300001",
            "country_code": "US",
            "telephone_number": "860-679-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHEN",
        "first_name": "ISABELLA",
        "middle_name": "YIROA",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-27",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "12847",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CT",
            "license": "12497",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235893",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

Verify at the official NPI Registry.