Individual provider Active NPI

Diana Lucia Cardona, DMD

  • General Practice Dentistry
  • Norwalk, CT
National Provider Identifier
1013225341
Registry record updated Jan 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
010629 Issued in CT
Practice address
49 Day St
Norwalk, CT 06854-4901
Phone
(203) 854-9292
Fax
(203) 854-9437
NPI assigned
Sep 21, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 010629 CT Primary

Addresses

Primary practice location

49 Day St
Norwalk, CT 06854-4901

Mailing address

635 Main St
Attn: Credentialing DPT
Middletown, CT 06457-2718
Phone (860) 347-6971

Other identifiers 1

IdentifierTypeStateIssuer
004236354MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150629001123 NY Order and Referring Only - DentistPractitioner - Dentist 3971815341

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010629CTMDGeneral Practice Dentistry
055250NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Westport Dental Studio PLLC Current Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327276800000",
    "number": "1013225341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 MAIN ST",
            "address_2": "ATTN: CREDENTIALING DPT",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064572718",
            "telephone_number": "860-347-6971",
            "fax_number": "860-638-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 DAY ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068544901",
            "telephone_number": "203-854-9292",
            "fax_number": "203-854-9437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDONA",
        "first_name": "DIANA",
        "middle_name": "LUCIA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-21",
        "last_updated": "2012-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "010629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004236354",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

Verify at the official NPI Registry.