Mashid Hedayati, D.D.S.

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

008073 Issued in CT

Practice address

1315 Main St
Willimantic, CT 06226-1948

Phone

(860) 450-7471

Fax

(860) 423-4629

NPI assigned

Dec 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1912065632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 MAIN ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062261948",
            "telephone_number": "860-450-7471",
            "fax_number": "860-423-4629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 MAIN ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062261948",
            "telephone_number": "860-450-7471",
            "fax_number": "860-423-4629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEDAYATI",
        "first_name": "MASHID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "008073",
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "CT",
            "license": "008073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dujuan J Harrison
• Ruth Rosemary Hartunian-Alumbaugh
• Haven Health Center of Winham, LLC
• Tracy Hawthorne, PA
• Crystal Eva Hayes, LPC
• Asia J Hedges
• Lisa Heidtmann
• Lynne Joy Hendzel, M.ED.
• Rebecca Hennessey, LMFT
• Jason Hernandez, DMD

• All providers in Willimantic, CT
• Public Health Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; 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.