James D Affenito, DMD
Individual provider Active NPI Oral and Maxillofacial Surgery (Dentist) · Bristol, CT
NPI 1164517033 · NPPES record last updated Jan 14, 2008
Key facts
- NPI
- 1164517033
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist) 1223S0112X
- License
- 7490 (CT)
- Practice address
- 391 Main St
Bristol, CT 06010-5848 - Phone
- (860) 589-1055
- Fax
- (860) 585-0251
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7490 | CT | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| O.M.S. Associates, P.C. | Past | Accepting new patients |
Interoperability endpoints
- jaffenito100551@direct.ynhh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 7490 | CT | Yes |
Addresses
Primary practice location
391 Main St
Bristol, CT 06010-5848
Mailing address
391 Main St
Bristol, CT 06010-5848
Phone (860) 589-1055
Other providers in Bristol, CT
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- Sharon Okin Adler
- Admire Dental LLC
- Advance Care Within LLC
- Affectionate Home Care Inc.
- Whitney O Agyeman
- Pamela Aiken
- Annas Al-Kalak
- Jacob Aldi
- Esther Alfisi
All providers in Bristol, CT · Oral and Maxillofacial Surgery (Dentist) in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 14, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.