Individual provider Active NPI

Jeffrey Wojewoda, DMD

  • Dentist
  • Torrington, CT
National Provider Identifier
1174972657
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
11832 Issued in CT
Practice address
55 Peck Rd
Torrington, CT 06790-6106
Phone
(860) 482-8588
NPI assigned
Jun 6, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 11832 CT Primary

Addresses

Primary practice location

55 Peck Rd
Torrington, CT 06790-6106

Mailing address

55 Peck Rd
Torrington, CT 06790
Phone (860) 482-8588

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
11832CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
DRS.Coutant, Sederqust & Nebor, Dentists,PC Past Accepting new patients
Northwest Corner Dental Partners LLP Past Accepting new patients

Organizations & group practices 2

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": "1465171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1174972657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 PECK RD",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "06790",
            "telephone_number": "860-482-8588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 PECK RD",
            "city": "TORRINGTON",
            "state": "CT",
            "postal_code": "067906106",
            "telephone_number": "860-482-8588"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOJEWODA",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-06",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CT",
            "license": "11832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.