Individual provider Active NPI

Satoko Ono Rubin, D.M.D., M.D.SC.

  • Prosthodontics
  • South Windsor, CT
National Provider Identifier
1083736219
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
010375 Issued in CT
Practice address
469 Buckland Rd
South Windsor, CT 06074-3737
Phone
(860) 644-2136
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 010375 CT Primary
Periodontics 1223P0300X 010375 CT

Addresses

Primary practice location

469 Buckland Rd
South Windsor, CT 06074-3737

Mailing address

1092 Farmington Ave Apt D
West Hartford, CT 06107-2140
Phone (617) 875-6839

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150821013247 CT Order and Referring Only - DentistPractitioner - Dentist 7315252210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010375CTMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405555200000",
    "number": "1083736219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1092 FARMINGTON AVE APT D",
            "city": "WEST HARTFORD",
            "state": "CT",
            "postal_code": "061072140",
            "telephone_number": "617-875-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "469 BUCKLAND RD",
            "city": "SOUTH WINDSOR",
            "state": "CT",
            "postal_code": "060743737",
            "telephone_number": "860-644-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBIN",
        "first_name": "SATOKO",
        "middle_name": "ONO",
        "credential": "D.M.D., M.D.SC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2014-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CT",
            "license": "010375",
            "primary": true
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CT",
            "license": "010375",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Windsor, CT

Sources for this page

Verify at the official NPI Registry.