Ident PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

IDENT PC

Practice address

711 Canal St # 250
Stamford, CT 06902-6094

Phone

(203) 548-0826

NPI assigned

Mar 22, 2021

Organization subpart

No

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

Authorized official

Name

Adam Sposato

Title

Operations Director

Phone

(646) 208-1456

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1616371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616371200000",
    "number": "1194301036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WESTAGE BUSINESS CTR DR STE 233",
            "city": "FISHKILL",
            "state": "NY",
            "postal_code": "125242262",
            "telephone_number": "845-897-2097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 CANAL ST # 250",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069026094",
            "telephone_number": "203-548-0826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "75 Holly Hill Ln",
            "address_purpose": "LOCATION",
            "city": "Greenwich",
            "state": "CT",
            "postal_code": "068306098",
            "country_code": "US",
            "telephone_number": "203-548-0826",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "330 Boston Post Rd",
            "address_purpose": "LOCATION",
            "city": "Darien",
            "state": "CT",
            "postal_code": "068203600",
            "country_code": "US",
            "telephone_number": "203-548-0826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IDENT PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-22",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A",
        "authorized_official_last_name": "SPOSATO",
        "authorized_official_first_name": "ADAM",
        "authorized_official_title_or_position": "OPERATIONS DIRECTOR",
        "authorized_official_telephone_number": "646-208-1456"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.