Active NPI
John G Fatse, D.M.D.
- General Practice Dentistry
- Monroe, CT
National Provider Identifier
1013285899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7150
- Practice address
- 324 Elm St
Suite 202a
Monroe, CT 06468-2280 - Phone
- (203) 268-5051
- Fax
- (203) 268-7988
- NPI assigned
- Dec 7, 2011
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7150 | CT | Primary |
Addresses
Primary practice location
324 Elm St
Suite 202a
Monroe, CT 06468-2280
Mailing address
324 Elm St
Suite 202a
Monroe, CT 06468-2280
Phone (203) 268-5051
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 |
|---|---|---|---|
| 7150 | CT | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323216000000",
"number": "1013285899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "324 ELM ST",
"address_2": "SUITE 202A",
"city": "MONROE",
"state": "CT",
"postal_code": "064682280",
"telephone_number": "203-268-5051",
"fax_number": "203-268-7988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "324 ELM ST",
"address_2": "SUITE 202A",
"city": "MONROE",
"state": "CT",
"postal_code": "064682280",
"telephone_number": "203-268-5051",
"fax_number": "203-268-7988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FATSE",
"first_name": "JOHN",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-07",
"last_updated": "2011-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CT",
"license": "7150",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.