NPIMap

Organization Active NPI

Durham Dental, PLLC

  • Dentist
  • Durham, CT
National Provider Identifier
1073090817
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11861 Issued in CT
Legal business name
DURHAM DENTAL, PLLC
Practice address
360 Main St Ste D
Durham, CT 06422-1644
Phone
(860) 349-1123
NPI assigned
Jul 24, 2018
Last updated
Jul 24, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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

Authorized official

Name
John ZyzoNPI 1336502301
Title
Dentist
Phone
(203) 233-7492

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11861 CT Primary

Addresses

Primary practice location

360 Main St Ste D
Durham, CT 06422-1644

Mailing address

360 Main St Ste D
Durham, CT 06422-1644
Phone (860) 349-1123

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1532390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532390400000",
    "number": "1073090817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 MAIN ST STE D",
            "city": "DURHAM",
            "state": "CT",
            "postal_code": "064221644",
            "telephone_number": "860-349-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 MAIN ST STE D",
            "city": "DURHAM",
            "state": "CT",
            "postal_code": "064221644",
            "telephone_number": "860-349-1123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DURHAM DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-24",
        "last_updated": "2018-07-24",
        "status": "A",
        "authorized_official_last_name": "ZYZO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "203-233-7492"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "11861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.