Active NPI
Michael Mark Perl, DDS
- Periodontics
- West Hartford, CT
National Provider Identifier
1013120906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- CT3765
- Practice address
- 61 S Main St
West Hartford, CT 06107-2486 - Phone
- (860) 236-2566
- Fax
- (860) 236-2282
- NPI assigned
- May 7, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | CT3765 | CT | Primary |
Addresses
Primary practice location
61 S Main St
West Hartford, CT 06107-2486
Mailing address
71 S Main St
Essex, CT 06426-1147
Phone (860) 767-1311
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
| License | State | Type | Specialty |
|---|---|---|---|
| CT3765 | CT | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178496000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013120906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "71 S MAIN ST",
"city": "ESSEX",
"state": "CT",
"postal_code": "064261147",
"telephone_number": "860-767-1311",
"fax_number": "860-767-2112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "61 S MAIN ST",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061072486",
"telephone_number": "860-236-2566",
"fax_number": "860-236-2282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERL",
"first_name": "MICHAEL",
"middle_name": "MARK",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CT",
"license": "CT3765",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.