Philip J Conforti, DDS

Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Hamden, CT

NPI 1053305201 · NPPES record last updated Mar 17, 2014

Key facts

NPI
1053305201
Entity type
Individual (NPI type 1)
Primary specialty
Oral and Maxillofacial Surgery (Dentist) 1223S0112X
License
6826 (CT)
Practice address
2560 Dixwell Ave Ste 2a
Hamden, CT 06514-1852
Phone
(203) 281-3737
Fax
(203) 230-2931
NPI assigned
Sep 2, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20190328002715 CT Order and Referring Only - Oral Surgery
Practitioner - Oral Surgery
5294832911

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 6826 CT Yes

Addresses

Primary practice location

2560 Dixwell Ave Ste 2a
Hamden, CT 06514-1852

Mailing address

87 State St
Guilford, CT 06437-2723
Phone (203) 453-4381

Other providers in Hamden, CT

All providers in Hamden, CT · Oral and Maxillofacial Surgery (Dentist) in Connecticut

Sources for this page

Verify at the official NPI Registry.