Active NPI
Ronald E. Wygonik, D.D.S.
- General Practice Dentistry
- Killingworth, CT
National Provider Identifier
1154491041
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5390
- Practice address
- 184 Route 81
Killingworth, CT 06419 - Phone
- (860) 663-2786
- Fax
- (860) 663-1589
- NPI assigned
- Nov 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5390 | CT | Primary |
Addresses
Primary practice location
184 Route 81
Killingworth, CT 06419
Mailing address
PO Box 690
Killingworth, CT 06419-0690
Phone (860) 663-2786
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150610002172 | CT | Order and Referring Only - Oral Surgery | 9537480900 |
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": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154491041",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 690",
"city": "KILLINGWORTH",
"state": "CT",
"postal_code": "064190690",
"telephone_number": "860-663-2786",
"fax_number": "860-663-1589"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "184 ROUTE 81",
"city": "KILLINGWORTH",
"state": "CT",
"postal_code": "06419",
"telephone_number": "860-663-2786",
"fax_number": "860-663-1589"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WYGONIK",
"first_name": "RONALD",
"middle_name": "E.",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CT",
"license": "5390",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Killingworth, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.