Active NPI
Vipasha Desai
- Dentist
- New London, CT
National Provider Identifier
1891059465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 010778
- Practice address
- 258 S Frontage Rd
New London, CT 06320-2641 - Phone
- (860) 347-3485
- NPI assigned
- Jun 28, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 010778 | CT | Primary |
| General Practice Dentistry | 1223G0001X | 010778 | CT |
Addresses
Primary practice location
258 S Frontage Rd
New London, CT 06320-2641
Mailing address
33 Horizon Hill Rd
Newington, CT 06111-5115
Phone (860) 371-5885
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010778 | CT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369008000000",
"number": "1891059465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "33 HORIZON HILL RD",
"city": "NEWINGTON",
"state": "CT",
"postal_code": "061115115",
"telephone_number": "860-371-5885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "258 S FRONTAGE RD",
"city": "NEW LONDON",
"state": "CT",
"postal_code": "063202641",
"telephone_number": "860-347-3485"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESAI",
"first_name": "VIPASHA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-28",
"last_updated": "2013-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CT",
"license": "010778",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CT",
"license": "010778",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New London, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.