Carlos Braverman, D.D.S.
Individual provider Active NPI General Practice Dentistry · Torrington, CT
NPI 1114134707 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1114134707
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 008745 (CT)
- Practice address
- 686 E Main St
Torrington, CT 06790-3931 - Phone
- (860) 489-9091
- Fax
- (860) 496-7110
- NPI assigned
- May 16, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150727002527 | CT | Order and Referring Only - Dentist |
3678887213 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 008745 | CT | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New Hartford Dental | General Practice | Past | Accepting new patients |
| Jorge F Baujin | General Practice | Past | Accepting new patients |
| B & B Dentistry LLC | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 008745 | CT | Yes |
Addresses
Primary practice location
686 E Main St
Torrington, CT 06790-3931
Mailing address
37 Simsbury Manor Dr
Weatogue, CT 06089-9709
Phone (860) 489-9091
Other providers in Torrington, CT
- Patricia L Bouchard
- Richard B Boulli Jr.
- Martha Jean Boyer
- Catharine S Branch
- Ariel Brandt
- Leigh S Brezenoff
- Britannia Health LLC
- Louise M Brockway
- Carolyn R Brown
- Donna C Brown
All providers in Torrington, CT · General Practice Dentistry in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.