Individual provider Active NPI

Jeffrey Dixon, DDS, M.S.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • East Hartford, CT
National Provider Identifier
1043321342
Registry record updated Sep 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
10256 Issued in CT
Practice address
477 Connecticut Blvd Ste 105
East Hartford, CT 06108-3228
Phone
(860) 289-9397
Fax
(860) 528-3129
NPI assigned
Aug 31, 2006
Last updated
Sep 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 20732 MA
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 10256 CT Primary

Addresses

Primary practice location

477 Connecticut Blvd Ste 105
East Hartford, CT 06108-3228

Mailing address

477 Connecticut Blvd Ste 105
East Hartford, CT 06108-3228
Phone (602) 899-3978

Other practice location 1

22 Upper Main St
Sharon, CT 06069-2083
Phone (860) 364-5006

Other practice location 2

232 Park St
West Springfield, MA 01089-3314
Phone (413) 737-2200

Other practice location 3

927 Hopmeadow St
Simsbury, CT 06070-1821
Phone (606) 519-5688

Other identifiers 1

IdentifierTypeStateIssuer
0298093MedicaidMA

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
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
West Springfield Orthodontics LLC Orthodontics and Dentofacial Orthopedics Current Accepting new patients
Dixon Orthodontics PLLC Orthodontics and Dentofacial Orthopedics Past Accepting new patients

Locations

232 Park St
West Springfield, MA 01089
Phone (413) 310-2604

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631059200000",
    "number": "1043321342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "477 CONNECTICUT BLVD STE 105",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083228",
            "telephone_number": "602-899-3978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "477 CONNECTICUT BLVD STE 105",
            "city": "EAST HARTFORD",
            "state": "CT",
            "postal_code": "061083228",
            "telephone_number": "860-289-9397",
            "fax_number": "860-528-3129"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22 Upper Main St",
            "address_purpose": "LOCATION",
            "city": "Sharon",
            "state": "CT",
            "postal_code": "060692083",
            "country_code": "US",
            "telephone_number": "860-364-5006",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "232 Park St",
            "address_purpose": "LOCATION",
            "city": "West Springfield",
            "state": "MA",
            "postal_code": "010893314",
            "country_code": "US",
            "telephone_number": "413-737-2200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "927 Hopmeadow St",
            "address_purpose": "LOCATION",
            "city": "Simsbury",
            "state": "CT",
            "postal_code": "060701821",
            "country_code": "US",
            "telephone_number": "606-519-5688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIXON",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DDS, M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-09-08",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MA",
            "license": "20732",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CT",
            "license": "10256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0298093",
            "state": "MA"
        }
    ],
    "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 Sep 8, 2021; 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.