Active NPI
Walter D Fonfara, DMD
- General Practice Dentistry
- Plainfield, CT
National Provider Identifier
1104979285
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 7841
- Practice address
- 699 Norwich Rd
Plainfield, CT 06374-1734 - Phone
- (860) 564-1689
- Fax
- (860) 564-1848
- NPI assigned
- Jan 19, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 7841 | CT | Primary |
Addresses
Primary practice location
699 Norwich Rd
Plainfield, CT 06374-1734
Mailing address
699 Norwich Rd
P.O. Box 71
Plainfield, CT 06374-1734
Phone (860) 564-1689
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walter D. Fonfara, D.D.S., P.C. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dentist
- Plainfield, CT
- NPI 1033440961
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104979285",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "699 NORWICH RD",
"address_2": "P.O. BOX 71",
"city": "PLAINFIELD",
"state": "CT",
"postal_code": "063741734",
"telephone_number": "860-564-1689",
"fax_number": "860-564-1848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "699 NORWICH RD",
"city": "PLAINFIELD",
"state": "CT",
"postal_code": "063741734",
"telephone_number": "860-564-1689",
"fax_number": "860-564-1848"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FONFARA",
"first_name": "WALTER",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CT",
"license": "7841",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plainfield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.