Individual provider Active NPI

Ted B Fischer, D.M.D.

  • General Practice Dentistry
  • Norwich, CT
National Provider Identifier
1124139696
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6864 Issued in CT
Practice address
17 Lafayette St
Norwich, CT 06360-3407
Phone
(860) 886-2497
Fax
(860) 886-6591
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6864 CT Primary

Addresses

Primary practice location

17 Lafayette St
Norwich, CT 06360-3407

Mailing address

17 Lafayette St
Norwich, CT 06360-3407
Phone (860) 886-2497

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
I20130909000025 CT Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8527201771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6864CTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Norwich Family Dental Associates General Practice PastSince Nov 13, 2017 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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124139696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 LAFAYETTE ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063603407",
            "telephone_number": "860-886-2497",
            "fax_number": "860-886-6591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 LAFAYETTE ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063603407",
            "telephone_number": "860-886-2497",
            "fax_number": "860-886-6591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCHER",
        "first_name": "TED",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "6864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

Verify at the official NPI Registry.