Michael Forman, D.M.D. , M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

13252 Issued in CT

Practice address

23 Maple Ave
Greenwich, CT 06830-5675

Phone

(203) 661-5858

NPI assigned

Mar 22, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: mif9089@direct.nyp.org

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671840000000",
    "number": "1043672967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 MAPLE AVE",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068305675",
            "telephone_number": "203-661-5858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 MAPLE AVE",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068305675",
            "telephone_number": "203-661-5858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "622 W 168th St",
            "address_2": "VC-7th Floor",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100323720",
            "country_code": "US",
            "telephone_number": "212-305-4552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORMAN",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D. , M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-22",
        "last_updated": "2022-12-24",
        "certification_date": "2022-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "062428",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CT",
            "license": "13252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott R Fisher, DMD
• Lucy D Flynn, M.D.
• Geoffrey Foat, R.P.T.
• Amy Ford, MSW
• Beth A Ford, PT
• Codi Forney
• Haley Sabina Fox, PA-C
• Nicole Franchella
• Gaetane C Francis, M.D.
• Michael J Franco, M.D.

• Oral and Maxillofacial Surgery (Dentist) in Greenwich, CT
• Providers in Greenwich, CT by specialty
• Oral and Maxillofacial Surgery (Dentist) in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2022; 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.