John Dannon, DMD

Individual provider Active NPI General Practice Dentistry · Canaan, CT

NPI 1003044157 · NPPES record last updated Jun 23, 2014

Key facts

NPI
1003044157
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
10357 (CT)
Practice address
60 Church St
Canaan, CT 06018-2481
Phone
(347) 267-1699
NPI assigned
Jun 29, 2009
Sex
Male
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20150521001956 CT Order and Referring Only - Dentist
Practitioner - Dentist
3375863962

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Housatonic Valley Dental Care Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 10357 CT Yes

Addresses

Primary practice location

60 Church St
Canaan, CT 06018-2481

Mailing address

60 Church St
Canaan, CT 06018-2481
Phone (347) 267-1699

Other identifiers

IdentifierTypeStateIssuer
008032193MedicaidCT

Other providers in Canaan, CT

All providers in Canaan, CT · General Practice Dentistry in Connecticut

Sources for this page

Verify at the official NPI Registry.