Itzel Medina, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

14051 Issued in CT

Practice address

319 Flanders Rd
East Lyme, CT 06333-1711

Phone

(860) 739-6915

NPI assigned

Aug 24, 2021

Last updated

Apr 6, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Zelmanow Dental LLC

  dba Zelmanow Dental

  • General Practice Dentistry
  • East Lyme, CT
  • NPI 1083244602
  NPD (past)

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

{
    "created_epoch": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775433600000",
    "number": "1023785334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 OCEAN AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 FLANDERS RD",
            "city": "EAST LYME",
            "state": "CT",
            "postal_code": "063331711",
            "telephone_number": "860-739-6915"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Wahoo Ave",
            "address_purpose": "LOCATION",
            "city": "Groton",
            "state": "CT",
            "postal_code": "063492324",
            "country_code": "US",
            "telephone_number": "860-694-3736 x1461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "ITZEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-24",
        "last_updated": "2026-04-06",
        "certification_date": "2026-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "14051",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02862000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maxcen Housing Society Inc Connecticut Branch
• Kelly Mazzulli
• Donald W McIntyre, PHD
• Sarah S McNamara, DPT
• Brenda B McNeil, APRN
• Donna Medolla
• Joanne Z. Moore, PT, DHS, OCS
• Cynthia Lorah Mostowy, AS, BS, RDH
• Moya Family Therapy, LLC
• Kelsey Murphy, M.A., CCC-SLP

• Dentist in East Lyme, CT
• Providers in East Lyme, CT by specialty
• Dentist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2026; 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.