Individual provider Active NPI

Ronald John Klinkowize, D.M.D.

  • General Practice Dentistry
  • Trumbull, CT
National Provider Identifier
1144356338
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
042007 Issued in CT
Practice address
15 Corporate Dr
Trumbull, CT 06611-1351
Phone
(203) 268-2600
Fax
(203) 459-1969
NPI assigned
Feb 24, 2007
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 042007 CT Primary

Addresses

Primary practice location

15 Corporate Dr
Trumbull, CT 06611-1351

Mailing address

37 Parley Rd
Ridgefield, CT 06877-1227
Phone (203) 431-0994

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

State licenses

LicenseStateTypeSpecialty
042007CTMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1172275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144356338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 PARLEY RD",
            "city": "RIDGEFIELD",
            "state": "CT",
            "postal_code": "068771227",
            "telephone_number": "203-431-0994",
            "fax_number": "203-431-0918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 CORPORATE DR",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066111351",
            "telephone_number": "203-268-2600",
            "fax_number": "203-459-1969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINKOWIZE",
        "first_name": "RONALD",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "042007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trumbull, 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.

Verify at the official NPI Registry.