Individual provider Active NPI

Grace A Nakos

  • Dentist
  • Glastonbury, CT
National Provider Identifier
1134499304
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
7620 Issued in CT
Practice address
141 Hebron Ave
Glastonbury, CT 06033-4200
Phone
(860) 633-5467
Fax
(860) 652-9318
NPI assigned
Jan 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 7620 CT Primary

Addresses

Primary practice location

141 Hebron Ave
Glastonbury, CT 06033-4200

Mailing address

141 Hebron Ave
Glastonbury, CT 06033-4200
Phone (860) 633-5467

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
I20150603001778 CT Order and Referring Only - DentistPractitioner - Dentist 9335460294

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7620CTMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Grace a. Nakos, DMD, P.C. Dentist 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.

NPI Registry JSON

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

{
    "created_epoch": "1325721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1134499304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 HEBRON AVE",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334200",
            "telephone_number": "860-633-5467",
            "fax_number": "860-652-9318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 HEBRON AVE",
            "city": "GLASTONBURY",
            "state": "CT",
            "postal_code": "060334200",
            "telephone_number": "860-633-5467",
            "fax_number": "860-652-9318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKOS",
        "first_name": "GRACE",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-05",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "7620",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glastonbury, CT

Sources for this page

Verify at the official NPI Registry.