Active NPI
Kiran Pervez
- Dentist
- Waterbury, CT
National Provider Identifier
1033093620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 14538
- Practice address
- 188 Chase Ave
Waterbury, CT 06704-2245 - Phone
- (203) 754-3818
- NPI assigned
- Aug 5, 2025
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 14538 | CT | Primary |
Addresses
Primary practice location
188 Chase Ave
Waterbury, CT 06704-2245
Mailing address
122 E Carpenter St
Valley Stream, NY 11580-4420
Phone (502) 919-3115
Other names 1
- Kiran Pervez
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 |
|---|---|---|---|
| 14538 | CT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Carol Dermesropian PLLC | Past | 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.
-
- General Practice Dentistry
- Waterbury, CT
- NPI 1982171401
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1754352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754352000000",
"number": "1033093620",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "122 E CARPENTER ST",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "115804420",
"telephone_number": "502-919-3115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "188 CHASE AVE",
"city": "WATERBURY",
"state": "CT",
"postal_code": "067042245",
"telephone_number": "203-754-3818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERVEZ",
"first_name": "KIRAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-08-05",
"last_updated": "2025-08-05",
"certification_date": "2025-08-05",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CT",
"license": "14538",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KIRAN",
"last_name": "PERVEZ",
"credential": "KIRAN PERVEZ",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.