Individual provider Active NPI

Jack Newton, DMD

  • Dentist
  • Southport, CT
National Provider Identifier
1073001475
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
12605 Issued in CT
Practice address
8 John St
Southport, CT 06890-1437
Phone
(203) 319-1300
Fax
(203) 319-0893
NPI assigned
May 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Dentist 122300000X 12605 CT Primary

Addresses

Primary practice location

8 John St
Southport, CT 06890-1437

Mailing address

8 John St
Southport, CT 06890-1437
Phone (203) 319-1300

Other practice location 1

4422 3rd Ave
Bronx, NY 10457-2545
Phone (718) 960-6628

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

LicenseStateTypeSpecialty
12605CTMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1073001475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 JOHN ST",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901437",
            "telephone_number": "203-319-1300",
            "fax_number": "203-319-0893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 JOHN ST",
            "city": "SOUTHPORT",
            "state": "CT",
            "postal_code": "068901437",
            "telephone_number": "203-319-1300",
            "fax_number": "203-319-0893"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4422 3rd Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104572545",
            "country_code": "US",
            "telephone_number": "718-960-6628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEWTON",
        "first_name": "JACK",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-01",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "12605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; 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.