Individual provider Active NPI

Charles Frank Labas Jr., DMD

  • General Practice Dentistry
  • Watertown, CT
National Provider Identifier
1164577557
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
5622 Issued in CT
Practice address
698 Main St
Watertown, CT 06795-2614
Phone
(860) 945-9265
Fax
(860) 945-9265
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
Yes

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 5622 CT Primary

Addresses

Primary practice location

698 Main St
Watertown, CT 06795-2614

Mailing address

698 Main St
P.O.Box235
Watertown, CT 06795-2614
Phone (860) 945-9265

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164577557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "698 MAIN ST",
            "address_2": "P.O.BOX235",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067952614",
            "telephone_number": "860-945-9265",
            "fax_number": "860-945-9265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "698 MAIN ST",
            "city": "WATERTOWN",
            "state": "CT",
            "postal_code": "067952614",
            "telephone_number": "860-945-9265",
            "fax_number": "860-945-9265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABAS",
        "first_name": "CHARLES",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "5622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, 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.