Organization Active NPI

Kasimer Kowalski DMD PC

  • Oral and Maxillofacial Surgery (Dentist)
  • East Hartford, CT
National Provider Identifier
1013932805
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
4001 Issued in CT
Legal business name
KASIMER KOWALSKI DMD PC
Practice address
477 Connecticut Blvd Ste 106
East Hartford, CT 06108-3228
Phone
(860) 289-4848
Fax
(860) 289-3798
NPI assigned
Jul 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Edward Sebastian Goracy
Title
President
Phone
(860) 289-4848

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist)Group: 193400000X SINGLE SPECIALTY GROUP 1223S0112X 4001 CT Primary

Addresses

Primary practice location

477 Connecticut Blvd Ste 106
East Hartford, CT 06108-3228

Mailing address

477 Connecticut Blvd Ste 106
East Hartford, CT 06108-3228
Phone (860) 289-4848

National Provider Directory

National Provider Directory

Locations

477 Connecticut Blvd
Ste 106
East Hartford, CT 06108
Phone (860) 289-4848

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013932805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 CONNECTICUT BLVD STE 106",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083228",
            "telephone_number": "860-289-4848",
            "fax_number": "860-289-3798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 CONNECTICUT BLVD STE 106",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083228",
            "telephone_number": "860-289-4848",
            "fax_number": "860-289-3798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KASIMER KOWALSKI DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GORACY",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "SEBASTIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-289-4848"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "4001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Hartford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.