Individual provider Active NPI

Estheffy Gonzalez Pantaleon

  • Dental Hygienist
  • New Haven, CT
National Provider Identifier
1003563842
Registry record updated Mar 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
009362 Issued in CT
Practice address
50 Grand Ave
New Haven, CT 06513-3949
Phone
(203) 777-7411
NPI assigned
Mar 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 009362 CT Primary

Addresses

Primary practice location

50 Grand Ave
New Haven, CT 06513-3949

Mailing address

50 Grand Ave
New Haven, CT 06513-3949
Phone (203) 777-7411

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address e.gonzalez-pantaleon@fhchc.org Direct

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

LicenseStateTypeSpecialty
009362CTMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646179200000",
    "number": "1003563842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 GRAND AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133949",
            "telephone_number": "203-777-7411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 GRAND AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065133949",
            "telephone_number": "203-777-7411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ PANTALEON",
        "first_name": "ESTHEFFY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-03-02",
        "certification_date": "2022-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CT",
            "license": "009362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "e.gonzalez-pantaleon@fhchc.org",
            "affiliation": "N",
            "endpointDescription": "e.gonzalez-pantaleon@fhchc.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "50 Grand Ave",
            "city": "New Haven",
            "state": "CT",
            "country_code": "US",
            "postal_code": "065133949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2022; 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.