Kelly Palchik DMD, PC

Primary specialty

DentistTaxonomy code 122300000X

License

010935 Issued in CT

Legal business name

KELLY PALCHIK DMD, PC

Practice address

84 Main St S
Woodbury, CT 06798-3403

Phone

(203) 263-2853

Fax

(203) 263-2859

NPI assigned

Nov 4, 2014

Last updated

Nov 4, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kelly Palchik, D.M.D

Title

Owner

Phone

(203) 263-2853

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gilbert I. Rubin, D.D.S.

  • Dentist
  • Woodbury, CT
  • NPI 1225174899
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1415059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415059200000",
    "number": "1003212937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84 MAIN ST S",
            "address_2": "PO BOX 407",
            "city": "WOODBURY",
            "state": "CT",
            "postal_code": "067983403",
            "telephone_number": "203-263-2853",
            "fax_number": "203-263-2859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "84 MAIN ST S",
            "city": "WOODBURY",
            "state": "CT",
            "postal_code": "067983403",
            "telephone_number": "203-263-2853",
            "fax_number": "203-263-2859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY PALCHIK DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-04",
        "last_updated": "2014-11-04",
        "status": "A",
        "authorized_official_last_name": "PALCHIK",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "203-263-2853",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CT",
            "license": "010935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Giustra-Kozek LPC LLC (Family Wellness and Psychotherapy Center)
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• John Louis Renzulli
• Heather Susan Jones, L.M.F.T
• Melissa Keilty, LMSW
• Kelly Tarascio LCSW
• Kenneth L. Burke, O.D.
• Kevin Moshier LCSW LLC
• Lana Lachance LLC
• Lance E. Banwell,DDS,PC

• Dentist in Woodbury, CT
• Providers in Woodbury, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.