Individual provider Active NPI

Anuya Diwan, B.D.S.

  • Dentist
  • Youngstown, OH
National Provider Identifier
1891059010
Registry record updated Feb 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.024295 Issued in OH
Practice address
500 Gypsy LN
Dental Department
Youngstown, OH 44504-1315
Phone
(330) 506-0987
NPI assigned
Jul 2, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 6, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X RES.3159 OH
Dentist 122300000X 30.024295 OH Primary

Addresses

Primary practice location

500 Gypsy LN
Dental Department
Youngstown, OH 44504-1315

Mailing address

3540 Springdale Rd
Cincinnati, OH 45251-1331
Phone (937) 902-9225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20150730013646 CA Order and Referring Only - DentistPractitioner - Dentist 4789998014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.024295OHMDDentist
RES.3159OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental First of Ohio LLC Current 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": "1341187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1891059010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 SPRINGDALE RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452511331",
            "telephone_number": "937-902-9225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 GYPSY LN",
            "address_2": "DENTAL DEPARTMENT",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445041315",
            "telephone_number": "330-506-0987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIWAN",
        "first_name": "ANUYA",
        "credential": "B.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-02",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "RES.3159",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.024295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngstown, OH

Sources for this page

Verify at the official NPI Registry.