Individual provider Active NPI

Edward A Dessau, D.C.

  • Rehabilitation Chiropractor
  • Shelton, CT
National Provider Identifier
1114008521
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
000751 Issued in CT
Practice address
45 White St
Shelton, CT 06484-3129
Phone
(203) 924-7557
Fax
(203) 924-1112
NPI assigned
Oct 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 000751 CT
Rehabilitation Chiropractor 111NR0400X 000751 CT Primary
Orthopedic Chiropractor 111NX0800X 000751 CT

Addresses

Primary practice location

45 White St
Shelton, CT 06484-3129

Mailing address

45 White St
Shelton, CT 06484-3129
Phone (203) 924-7557

Other identifiers 1

IdentifierTypeStateIssuer
4090487MedicaidCT

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1114008521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 WHITE ST",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064843129",
            "telephone_number": "203-924-7557",
            "fax_number": "203-924-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 WHITE ST",
            "city": "SHELTON",
            "state": "CT",
            "postal_code": "064843129",
            "telephone_number": "203-924-7557",
            "fax_number": "203-924-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESSAU",
        "first_name": "EDWARD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CT",
            "license": "000751",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "CT",
            "license": "000751",
            "primary": true
        },
        {
            "code": "111NX0800X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Orthopedic",
            "state": "CT",
            "license": "000751",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4090487",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.