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Madhur Upadhyay

Dentist

Dental Providers

263 Farmington Ave, Farmington, CT 06030-0001

(860) 679-2000 (860) 335-4517

PECOS Enrollment

Based on the most recent information from CMS, provider Madhur Upadhyay is legally eligible to order and refer claims for Part B, HHA and DME services only.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1104088954
Provider Type
Individual
Full Name
Upadhyay, Madhur
Credential
BDS, MDS

Gender
Male
Sole Proprietor
No
Enumeration Date
7/1/2008
Last Updated
4/23/2021

Contact Information

Practice Location

263 Farmington Ave, Farmington, CT 06030-0001

(860) 679-2000

Unlisted Fax

Mailing Location

9 Bogart Lane, Newington, CT 06111-2919

(860) 335-4517

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1223X0400X Primary	Description Dentist Dental Providers	License 12384 Connecticut
Code 1223X0400X	Description Dentist Dental Providers	License 010366 Connecticut

Madhur Upadhyay

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Nanda, Anjali

Uribe, Flavio

Knecht, Kristen Marie

Dutra, Eliane Hermes

Grover, Shaifali

Mukherjee, Padma

Janakiraman, Nandakumar

Banankhah, Sina

Chandhoke, Taranpreet

Azami, Niloufar