Active NPI
Irene Ellison
- Dental Hygienist
- Bridgeport, CT
National Provider Identifier
1083697916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- Practice address
- 471 Barnum Ave
Bridgeport, CT 06608-2409 - Phone
- (203) 333-6864
- Fax
- (203) 333-6864
- NPI assigned
- Nov 23, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | Primary |
Addresses
Primary practice location
471 Barnum Ave
Bridgeport, CT 06608-2409
Mailing address
471 Barnum Ave
Bridgeport, CT 06608-2409
Phone (203) 333-6864
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 001954 | Other | CT | STATE LICENSE |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1083697916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "471 BARNUM AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066082409",
"telephone_number": "203-333-6864",
"fax_number": "203-333-6864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "471 BARNUM AVE",
"city": "BRIDGEPORT",
"state": "CT",
"postal_code": "066082409",
"telephone_number": "203-333-6864",
"fax_number": "203-333-6864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLISON",
"first_name": "IRENE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-23",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "001954",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bridgeport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.